Resection of Deep-seated Gliomas Using Neuroimaging for Stereotactic Placement of Guidance Catheters
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概要
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A simple computed tomography- (CT) or magnetic resonance (MR) imaging-guided stereotactic method for guided microsurgical resection of either deep-seated gliomas or tumors adjacent to an eloquent area is described. The technique employs the Brown-Roberts-Wells stereotactic system and twist drills, 2.7 mm in diameter, for the stereotactic placement of 2.4 mm diameter scaled guidance catheters through the calvaria. In a patient with a deep-seated small glioma, less than 2 cm diameter, one catheter was implanted into the center of the enhanced mass through the cerebral cortex. In the other 14 patients, three to six catheters were used which made the tumor border clearer. After implantation of the guidance catheters, the stereotactic frame was removed and a standard open craniotomy performed. Target localization is not affected by brain movement, which is inevitable during open surgery. The tumor involved the frontal lobe in eight patients, the parietal lobe in two, and the thalamus in five. In all cases the lesion was quickly localized and radical removal was achieved. Neurological complications occurred in only one patient who suffered transient hemiparesis after the resection of a lesion in the pyramidal tract. The results demonstrate that microsurgery combined with CT- or MR imaging-guided stereotactic placement of guidance catheters is a new option for surgery of deep-seated gliomas or tumors adjacent to an eloquent area.
- 日本脳神経外科学会の論文
- 1995-03-15
著者
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松本 健五
信州大学 脳神経外科
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Ohmoto Takashi
Department Of Neurological Surgery Okayama University Medical School
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Matsumoto Kengo
Department Of Cardiology National Hospital Organization Kure Medical Center
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Tomita Susumu
Department Of Neurological Surgery Okayama University Medical School
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Higashi Hisato
Department Of Neurological Surgery Okayama University Medical School
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Furuta Tomohisa
Department Of Neurological Surgery Okayama University Medical School
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Furuta Tomohisa
Department Of Biochemistry Fukushima Medical University
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Ohmoto Takashi
Department Of Neurological Surgery Kagawa Medical School
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FURUTA Tomohisa
Department of Neurological Surgery, Okayama, University Medical School
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OHMOTO Takashi
Department of Neurological Surgery, Okayama University Medical, School
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OHMOTO Takashi
Department of Environmental Technology, Osaka Municipal Technical Research Institute
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