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CURRENT ISSUEJOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery

Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

Frequency: Bi-Monthly

ISSN 0390-5616

Online ISSN 1827-1855

 

Journal of Neurosurgical Sciences 2015 Jul 14

A simple, safe and effective surface marking and targeting method combined with intraoperative ultrasonography for small subcortical intracranial lesions

Kazanci A. 1, Gurcan O. 1, Gurcay A. G. 1, Bozkurt I. 1, Algin O. 2, Turkoglu O. F. 1, Bavbek M. 3

1 Ankara Ataturk Research and Training Hospital Neurosurgery Department, Ankara, Turkey;
2 Ankara Ataturk Research and Training Hospital, Department of Radiology, Ankara, Turkey;
3 Yildirim Beyazit University, School of Medicine, Department of Neurosurgery, Ankara, Turkey

Accurately locating small subcortical brain lesions is very important for maximal surgical resection with minimal neurological damage. Intraoperative MRI has proved to be more precise than ultrasound, it is relatively expensive and isn’t available in all centers. Herein we describe a new, simple, safe and effective method for determining a small skin incision and craniotomy via skin staples combined with intraoperative ultrasonography to determine the margins, vascularity and residue of the lesion. Thirty three patients with small subcortical lesions were admitted into the study. The maximum diameter of the lesions ranged between 18 and 30 mm. The depth of the lesion was described as the distance between the cortical surface and most outer point of the lesion. The mean of the depth of the lesions was 10.56 mm ranging between 3.3 and 18.7 mm. Multiple skin staples were used as irremovable skin markers. Before and after dural incision, ultrasound was used to assess the lesion size and location, its relationship with the surrounding tissue and the Doppler function to reveal the blood supply to the lesion. In this study mean craniotomy diameter was 44 mm ranging between 32-55 mm. The location, extent, characteristics and adjacent tissue of the lesion were observed by high frequency ultrasonography during the operation. We describe a simple, safe and effective method for determining a small skin incision and craniotomy combined with intraoperative ultrasound for small subcortical intracranial lesions for health center that does not have intraoperative MRI and navigation systems.

language: English


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