Consideration of Intraoperative Brain Shift for Frameless Stereotaxy

Brain shift during open neurosurgery is a major factor causing errors in intraoperative neuronavigation based on preoperative neuroradiological images. Under the observation of intraoperative CT images provided by the operating CT scanner system in Shinshu University Hospital, the causes of intraoperative brain shift were analyzed. As direct surgical factors of intraoperative brain shift, decompressive effects by craniotomy, dural opening, and suction of cerebrospinal fluid may play a significant role on intraoperative shift. Also, surgical procedures including brain retraction and dissection significantly affect intraoperative CT findings. Furthermore, changes of brain volume by administration of anesthetic and osmotic agents and intraoperative management of respiration and blood pressure may be important indirect factors in intraoperative brain shift affecting neuronavigation.

[1]  T Takizawa,et al.  Isocentric stereotactic three-dimensional digitizer for neurosurgery. , 1993, Stereotactic and functional neurosurgery.

[2]  S. Kobayashi,et al.  Modified head fixation system for intraoperative CT scanning--technical note. , 1992, Neurologia medico-chirurgica.

[3]  G H Barnett,et al.  Application of frameless stereotaxy to pedicle screw fixation of the spine. , 1995, Journal of neurosurgery.

[4]  J. Strohbehn,et al.  A frameless stereotaxic integration of computerized tomographic imaging and the operating microscope. , 1986, Journal of neurosurgery.

[5]  Intraoperative computed tomographic scanning during transsphenoidal surgery: technical note. , 1993, Neurosurgery.

[6]  L D Lunsford,et al.  Intraoperative navigation during resection of brain metastases. , 1996, Neurosurgery clinics of North America.

[7]  H. Nauta,et al.  Error assessment during "image guided" and "imaging interactive" stereotactic surgery. , 1994, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[8]  L. Smith,et al.  Clinical use of a frameless stereotactic arm: results of 325 cases. , 1995, Journal of neurosurgery.

[9]  K. Takakura,et al.  Three-dimensional digitizer (neuronavigator): new equipment for computed tomography-guided stereotaxic surgery. , 1987, Surgical neurology.

[10]  K. Smith,et al.  The NeuroStation--a highly accurate, minimally invasive solution to frameless stereotactic neurosurgery. , 1994, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[11]  G H Barnett,et al.  Intraoperative localization using an armless, frameless stereotactic wand. Technical note. , 1993, Journal of neurosurgery.

[12]  Gene H. Barnett,et al.  Use of a Frameless, Armless Stereotactic Wand for Brain Tumor Localization with Two-Dimensional and Three-Dimensional Neuroimaging , 1993 .

[13]  S J Zinreich,et al.  In vivo accuracy testing and clinical experience with the ISG Viewing Wand. , 1996, Neurosurgery.

[14]  D. Long,et al.  Frameless stereotaxic integration of CT imaging data: accuracy and initial applications. , 1993, Radiology.

[15]  G. Horstmann,et al.  Sonic stereometry in microsurgical procedures for deep-seated brain tumors and vascular malformations. , 1993, Neurosurgery.

[16]  C. Pelizzari,et al.  Frameless stereotaxy with real-time tracking of patient head movement and retrospective patient-image registration. , 1996, Journal of neurosurgery.

[17]  T. Yoshimine,et al.  A frameless, armless navigational system for computer-assisted neurosurgery. Technical note. , 1991, Journal of neurosurgery.

[18]  H. Coakham,et al.  Advances in image-directed neurosurgery: preliminary experience with the ISG Viewing Wand compared with the Leksell G frame. , 1994, British journal of neurosurgery.

[19]  S Manaka,et al.  Open surgery assisted by the neuronavigator, a stereotactic, articulated, sensitive arm. , 1991, Neurosurgery.

[20]  David W. Roberts,et al.  Extracranial application of the frameless stereotactic operating microscope: experience with lumbar spine. , 1993, Neurosurgery.

[21]  L. Lemieux,et al.  Accuracy in frame-based and frameless stereotaxy. , 1993, Stereotactic and functional neurosurgery.

[22]  N. Glossop,et al.  Computer‐Aided Pedicle Screw Placement Using Frameless Stereotaxis , 1996, Spine.

[23]  K Kyoshima,et al.  Intraoperative CT scan findings during resection of glial tumours. , 1994, Neurological research.

[24]  K. K. Tan,et al.  A frameless stereotactic approach to neurosurgical planning based on retrospective patient-image registration. Technical note. , 1993, Journal of neurosurgery.

[25]  S. Kobayashi,et al.  Technical note: mobile CT scanner gantry for use in the operating room. , 1991, AJNR. American journal of neuroradiology.

[26]  L Zamorano,et al.  Computer-assisted neurosurgery system: Wayne State University hardware and software configuration. , 1994, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.