PURPOSE: This paper proposes a practical model of microneurosurgical training using a nonliving swine head. METHODS:Fresh porcine heads were obtained from butchery and dissected at our Laboratory of Microsurgery. Brain and skull base surgery were trained under microscopic magnification. RESULTS:Several neurosurgical procedures could be simulated in the nonliving pig model, including transcallosal approach to the lateral ventricle, lateral sulcus and middle fossa dissection, and posterior fossa surgery. CONCLUSION:The swine model perfectly simulates standard microneurosurgical procedures, and is a useful tool for developing and refining surgical skills.

In patients with presumed idiopathic syringomyelia, imaging studies should be closely inspected for the presence of transverse arachnoid web. This extramedullary transverse band of arachnoid tissue extends to dorsal surface of the spinal cord, resulting in mass effect and dorsal indentation, known as scalpel sign because of its apparent resemblance to a scalpel on sagittal imaging. Early diagnosis with early intervention may benefit greatly patients. Surgical resection of transverse arachnoid web is a minimally invasive procedure with low morbidity, and can result in resolution of syringomyelia and improvement in neurological function.

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Brazil 2. Frame-based versus frameless image-guided surgery Frame-based stereotactic resection was the first navigation method, rooted in cartesian coordinate system developed by Clarke and Horsley in the 1900s, and is still traditionally www.intechopen.com

RESUMODe acordo com sua localização, o tratamento cirúrgico dos meningiomas intracranianos pode ser de grande desafio para o neurocirurgião. A aplicação de neuronavegação na ressecção de meningiomas é comumente relacionada à localização do tumor, no entanto, este conceito é válido apenas para as lesões localizadas na convexidade. O uso da navegação pode variar desde a localização da craniotomia até a localização de fibras da substância branca, áreas eloquentes e estruturas neurovasculares durante a ressecão de tumoração profunda. Em alguns casos, a neuronavegação pode não ser essencial, mas, se disponível, pode promover uma maior segurança ao tratamento cirúrgico. O objetivo deste artigo é mostrar como aprimorar o uso da neuronavegação para cirurgias de meningiomas intracranianos. Palavras-chave: Neuronavegação; Meningioma; Cirurgia assistida por computador.ABSTRACT According to its location, the surgical treatment of intracranial meningioma can be of considerable challenge for the neurosurgeon. The aplication of neuronavigation for meningioma surgery is commonly related to tumor localization. However, this concept is applied only to convexity located lesions. Its usage can range from a simple craniotomy flap localization to a deep brain tumor resection respecting tract fibers, eloquent areas and neurovascular structures. In some cases, neuronavigation may not be necessary, but, if avaliable, it should promotes a safer surgery, as it has yet to become an integral part of intracranial procedures. The aim of this article is show how to enhance the neuronavigation usage for meningioma surgery.