Journal
STEREOTACTIC AND FUNCTIONAL NEUROSURGERY
Volume 87, Issue 1, Pages 18-24Publisher
KARGER
DOI: 10.1159/000177624
Keywords
Neuronavigation; Brain shift; Intraoperative magnetic resonance imaging; Subcortical stimulation; Pyramidal tract; Diffusion-weighted imaging; Functional mapping; Fiber tracking
Categories
Ask authors/readers for more resources
Background/Aims: To identify the pyramidal tract by neuronavigation based on intraoperative diffusion-weighted imaging (iDWI) combined with subcortical stimulation. Methods: Seven patients with brain tumors near the deep white matter underwent resection surgery using neuronavigation based on iDWI to visualize white matter bundles. Subcortical electrical stimulation was performed and electromyography was measured at the extremities when surgical manipulation came near the position corresponding to the depicted bundle. We validated the bundle depicted on iDWI by considering the responses to subcortical stimulation and the distance between the stimulation site and the depicted bundle. Results: Positive motor-evoked potentials were detected in 5 of 7 patients (8 stimulations) and the distance from the stimulation site to the depicted bundle was 0-4.7 mm (mean +/- SD, 1.4 +/- 2.1 mm). Negative (no) responses were obtained in all patients when the distance was more than 5 mm. The neuronavigation system had an average error of 0.79 +/- 0.25 mm and a maximum error of 2.0 mm (n = 16). Conclusion: Neuronavigation based on iDWI combined with subcortical stimulation allowed surgeons to identify the pyramidal tract and avoid inadvertent injury. Our findings demonstrate that the white matter bundles depicted by iDWI can contain the pyramidal tract. Copyright (c) 2008 S. Karger AG, Basel
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available