Frameless Nonstereotactic Image-Guided Surgery of Supratentorial Lesions: Introduction to a Safe and Inexpensive Technique

Abstract

The lesions were accessed through an optimally suited craniotomy. The visual matching of the cortical surface with reconstructed 3D images of the cortex permitted a fast localization of cortical and subcortical lesions. The major limitation is the depth of a lesion deeper than 3 cm. In these cases, the use of frame-based or frameless techniques still seems safer and more advantageous. Conclusions: The shape recognition of the cortical landmarks was not biased by brain distortion because the sulci and cortical vessels almost always had a relationship to each other that was not modified by edema or cerebrospinal fluid leakage. This 3DR allows us to reconstruct a virtual anatomy in an easy, portable, and inexpensive way. In selected cases, this technique represents a valid and safe alternative to the use of costly neuronavigation tools and is potentially helpful in developing countries.