2009
DOI: 10.3171/2008.6.jns17611
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Neuronavigation and fluoroscopy-assisted subdural strip electrode positioning: a simple method to increase intraoperative accuracy of strip localization in epilepsy surgery

Abstract: For localization of the epileptogenic zone in cases of focal epilepsy, detailed clinical investigations, imaging studies, and electrophysiological methods are used. If the noninvasive presurgical evaluation provides insufficient data, intracranial electrodes are necessary. Computed tomography and MR imaging techniques are the gold standard for localization of the postoperative position of the implanted intracranial electrode contacts. If the electrode strips are inserted through a bur hole, however, the exact … Show more

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Cited by 20 publications
(13 citation statements)
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“…A large tumor usually deforms the anatomic structure, leading to the compression and extrusion of the brain stem, cerebellum hemisphere, and nerves [2]. Thus, CT/MRI scans are the gold standard to follow neurosurgical procedures [7,8]. The present data indicated that ultrasonic images recorded immediately after the operation detected fragments of a residual tumor, which was consistent with postoperative CT/MRI scans.…”
Section: Discussionsupporting
confidence: 80%
“…A large tumor usually deforms the anatomic structure, leading to the compression and extrusion of the brain stem, cerebellum hemisphere, and nerves [2]. Thus, CT/MRI scans are the gold standard to follow neurosurgical procedures [7,8]. The present data indicated that ultrasonic images recorded immediately after the operation detected fragments of a residual tumor, which was consistent with postoperative CT/MRI scans.…”
Section: Discussionsupporting
confidence: 80%
“…Following noninvasive presurgical evaluation, patients underwent subdural strip, grid and depth electrode implantation (NSLIJ: Integra Lifesciences Corp., Plainsboro, New Jersey, NIN: AD TECH Medical Instrument Corp., Racine, WI). Subdural electrodes (10 mm intercontact spacing) were implanted with the aid of neuronavigation and fluoroscopy to maximize accuracy [Eross et al, ] via craniotomy with targets defined by clinical grounds. Video‐EEG monitoring was performed using Xltek EMU 128 LTM System (San Carlos, CA) at NSLIJ and a Brain Quick System 98 (Micromed, Mogliano Veneto, Italy) at NIN.…”
Section: Methodsmentioning
confidence: 99%
“…Moreover, fluoroscopy is limited in its ability to detect medial and/or lateral lead deviations, and radiographic studies do not easily fuse with preoperative neuronavigation plans developed from CT and MRI. 4,11 Intraoperative CTs (iCTs) can be obtained in standard operating rooms using the portable O-arm image acquisition system (Medtronic Inc.). This technique has been described in deep brain stimulation (DBS) surgery for confirming the accurate placement of electrodes into deep brain structures, 14 but its use in epilepsy surgery has not been investigated.…”
mentioning
confidence: 99%