caa a22 4500 477108539 CHVBK 20180405111602.0 cr unu---uuuuu 170330e19960201xx s 000 0 eng 10.1007/BF01411361 doi (NATIONALLICENCE)springer-10.1007/BF01411361 Computer assisted brain surgery for small lesions in the central sensorimotor region [Elektronische Daten] [H. Reinhardt, M. Trippel, B. Westermann, G. Horstmann, O. Gratzl] Summary: The capacity of a new optical navigation device is demonstrated by six microsurgical procedures for small subcortical lesions within the central sensorimotor strip. This small series is aimed at less invasive resection in this functionally critical region, independently of primary diagnosis and outcome. Guided by high resolution CT imaging data five brain tumours and one cavernous angioma was selectively located and most sparingly removed without additional sensorimotor deficit. In two cases improvement of a pre-operative paresis was observed immediately after surgery. Thanks to light-weight freehand pointing instruments and a ranging accuracy of +/- 1 mm, damage to functionally important brain areas and vessels was avoided by using uncommonlyoblique, e.g., transsulcal ways of access which would hardly have been possible even with guidance by conventional stereotaxy. The demanding systematic cortical stimulation of the precentral gyrus applied in three cases was only sensitive in infiltrating tumours — e.g., low grade astrocytomas — where for want of adjuvant therapy it was essential to proceed to the extreme limits of resection. In general, precise anatomical localisation by computer aided surgery (CAS) is sufficient in small central lesions which guarantees minimally invasive surgery. The potential of this new, soon commercially available optical navigation system in (neuro)surgery, quality control and teaching is discussed. Springer-Verlag, 1996 Free hand navigation nationallicence optical digitizer nationallicence frameless stereotaxy nationallicence CT- /MRI-/ image guided brain surgery nationallicence computer aided (assisted) surgery nationallicence CAS nationallicence central sensorimotor region nationallicence brain tumour nationallicence cavernoma nationallicence neurosurgery nationallicence Reinhardt H. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut Trippel M. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut Westermann B. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut Horstmann G. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut Gratzl O. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut Acta Neurochirurgica Springer-Verlag 138/2(1996-02-01), 200-205 0001-6268 138:2<200 1996 138 701 https://doi.org/10.1007/BF01411361 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01411361 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Reinhardt H. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut NATIONALLICENCE 700 1- Trippel M. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut NATIONALLICENCE 700 1- Westermann B. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut NATIONALLICENCE 700 1- Horstmann G. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut NATIONALLICENCE 700 1- Gratzl O. Neurosurgical University Clinic, Kantonsspital Basel, Switzerland aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/2(1996-02-01), 200-205 0001-6268 138:2<200 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer