Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Grunert, P; Charalampaki, K; Kassem, M; Boecher-Schwarz, H; Filippi, R; Grunert, P.
Frame-based and frameless stereotaxy in the localization of cavernous angiomas.
Neurosurg Rev. 2003; 26(1):53-61
Doi: 10.1007/s10143-002-0223-z
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Charalampaki Patra
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- Abstract:
- Cavernous angiomas are mostly small intracranial vascular lesions which can be intraoperatively localized by sonography or stereotactic methods. This paper compares the results of cavernous angioma surgery localized by frame-based vs frameless techniques. Thirty-nine patients with cortical or subcortical lobar cavernoma were operated on by a microsurgical trans-sulcal approach. The localization of the lesion was performed in 19 (49%) patients by frame-based technique and in 20 (51%) patients by frameless navigation. In 22 (56%) of the patients, the cavernomas were located in an eloquent cortical area. Ten of 22 of these lesions were localized by frame-based stereotaxy and 12/22 by frameless navigation. The patients demonstrated the following preoperative symptoms: seizures 20 (51%), hemorrhage 18 (46%), focal neurologic deficit 11 (28%), and headache three (7%), and three (7%) were asymptomatic. Thirteen of 19 patients localized with frame-based stereotaxy were postoperatively asymptomatic or their preoperative neurological symptoms improved. Four of 19 had a transitory neurologic deficit and 2/19 a permanent worsening. Seventeen of 20 patients localized by frameless navigation were asymptomatic or neurologically improved. Three out of 20 suffered from a transient neurologic deficit. Regarding the seizures, 14 (70%) patients were postoperatively free of seizures, three (15%) were improved, and three (15%) were unchanged. The frameless navigation was superior regarding the flexibility for approaches along the skull base and midline, and the frame-based method was superior regarding the accuracy for very small lesions (less than 7 mm). In other cases, both methods were equal. Frame-based and frameless stereotactic methods are useful in the localization of small cavernous angiomas. They make it possible to remove cavernous angiomas in eloquent cortical regions with low risk of a permanent neurologic deficit.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Brain Neoplasms - complications
- Female - complications
- Hemangioma, Cavernous - complications
- Humans - complications
- Male - complications
- Middle Aged - complications
- Nervous System Diseases - etiology
- Neuronavigation - adverse effects
- Outcome Assessment (Health Care) - adverse effects
- Postoperative Complications - adverse effects
- Retrospective Studies - adverse effects
- Risk Assessment - adverse effects
- Severity of Illness Index - adverse effects
- Find related publications in this database (Keywords)
- frame-based stereotaxy
- frameless navigation
- intraoperative localization
- cavernous angiomas
- clinical outcome
- epileptic seizures