Minim Invasive Neurosurg 2001; 44(1): 13-16
DOI: 10.1055/s-2001-14511
ORIGINAL PAPER
Georg Thieme Verlag Stuttgart · New York

Minimally Invasive Craniotomy Using the Steiner-Lindquist Stereotaxic Guide

A. Bekar, E. Korfali, B. Çalişir, Ş. Tolunay
  • Departments of Neurosurgery and Pathology, Uludağ University School of Medicine, Bursa, Turkey
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Thirty-three obscure intracranial lesions were located using the Steiner-Lindquist microsurgical stereotaxic guide and then surgically resected. Seventeen of the lesions were located in the parietal region, six in the frontal region, three in the parietooccipital region, three in the temporoparietal region, one in the thalamic region, one in the centrum semiovale, one in the brainstem, and one in the third ventricle. Twenty-three lesions were in subcortical or cortical locations. In 28 cases, the lesion was totally removed, while in 5 the lesion was subtotally resected. Pathological examinations confirmed glial tumor in eight patients, metastasis in seven, meningioma in two, cavernous angioma in eight, arteriovenous malformation (AVM) in four, hematoma in two, dysembryoblastic neuroepithelial tumor in one, and septum pellucidum cyst in one. Two patients developed transient complications postsurgery. Mean lesion size was 23 ± 0.97 mm. The hospitalization period ranged from 1 to 6 days (mean 3.4 ± 1.3 days). Surgeries were performed under general anesthesia, or under local anesthesia with the patient awake. The Steiner-Lindquist microsurgical stereotaxic guide is useful for pinpointing small lesions, especially those in the subcortical and deep areas. Knowing the precise location of the lesion facilitates removal through a small craniotomy incision. This minimally invasive procedure reduces the number of postoperative neurological complications, and also cuts costs by shortening the hospital stay.

References

  • 1 Ebeling U, Hasdemir M G. Stereotactic guided microsurgery of cerebral lesions.  Minim Invas Neurosurg. 1995;  38 10-15
  • 2 Mathiesen T, Lindquist C, Kihlström L. Microsurgery with the Steiner-Lindquist stereotaxic guide.  Br J Neurosurg. 1996;  10 155-160
  • 3 Kelly P J. Future perspectives in stereotactic neurosurgery: stereotactic microsurgical removal of deep brain tumours.  Neurosurg Sci. 1989;  33 149-154
  • 4 Kelly P J. Image-directed tumour resection.  Neurosurg Clin North Am. 1990;  1 81-95
  • 5 Dorward N L. Neuronavigation - the surgeon's sextant.  Br J Neurosurg. 1997;  11 101-103
  • 6 Leksell L, Lindquist C, Adler J R, Leksell D, Jernberg B, Steiner L. A new fixation device for the Leksell stereotaxic system. Technical note.  J Neurosurg. 1987;  66 626-629
  • 7 Steiner L, Lindquist C. A stereotactic guide for microsurgery: technical note.  Acta Neurochir (Wien). 1994;  129 82-84
  • 8 Kelly P J. Volumetric stereotactic surgical resection of intraaxial brain mass lesions.  Mayo Clin Proc. 1988;  63 1186-1198
  • 9 Lunsford L D, Rosenbaum A E, Perry J. Stereotactic surgery using ‘Therapeutic’ CT scanner.  Surg Neurol. 1982;  18 116-122
  • 10 Jacques S, Shelden H, McCann G D, Frechwater D B, Rand R. Computerized three-dimensional stereotaxic removal of small central nervous system lesions in patients.  J Neurosurg. 1980;  53 816-820
  • 11 Esposito V, Oppido P A, Delfini R, Cantore G. A simple method for stereotactic microsurgical excision of small, deep-seated cavernous angiomas.  Neurosurgery. 1994;  34 515-519
  • 12 Giorgi C, Ongania E, Casolino S D, Riva D, Cella G, Franzini A, Broggi G. Deep-seated cerebral lesion removal, guided by volumetric rendering of morphological data, stereotactically acquired clinical results, and technical considerations.  Acta Neurochir. 1991;  Suppl 52 19-21
  • 13 Riechert T, Mundinger F. Combined stereotaxic operation for treatment of deep-seated angiomas and aneurysms.  J Neurosurg. 1964;  21 358-363
  • 14 Kucharczyk W, Bernstein M. Do the benefits of image guidance in neurosurgery justify the costs? From stereotaxy to intraoperative MR.  AJNR. 1997;  18 1855-1859
  • 15 Savaş A, Egemen N, Berk Ç. Stereotactically guided craniotomy for a cavernous hemangioma: technical note.  Turkish Neurosurg. 1998;  8 110-113
  • 16 Davis D H, Kelly P J. Stereotactic resection of occult vascular malformations.  J Neurosurg. 1990;  72 698-702
  • 17 Kelly P J, Alker G J, Zoll J G. A microstereotactic approach to deep-seated arteriovenous malformations.  Surg Neurol. 1982;  17 260-262
  • 18 Sisti M B, Solomon R A, Stein B M. Stereotactic craniotomy in the resection of small arteriovenous malformations.  J Neurosurg. 1991;  75 40-44
  • 19 Hariz M, Fodstad I H. Stereotactic localisation of small subcortical brain tumours for open surgery.  Surg Neurol. 1987;  28 345-350
  • 20 Kelly P J. Stereotactic technology in tumour surgery.  Clin Neurosurg. 1989;  35 215-253
  • 21 Stern W E. Preoperative evaluation: complications, their prevention and treatment. In: Youmans TR (ed.). Neurological Surgery. Vol 2 Philadelphia: Saunders 1982: 1057-1116
  • 22 Barnett G H, McKenzie R L, Ramos L, Palmer J. Nonvolumetric stereotaxy-assisted craniotomy. Results in 50 consecutive cases.  Stereotact Funct Neurosurg. 1993;  61 80-95

Corresponding Author

A Bekar,M. D 

Department of Neurosurgery
Uludağ University
School of Medicine

Görükle
16059 Bursa
Turkey

Phone: Phone:+90-224-442-8081

Fax: Fax:+90-224-442-8034

Email: E-mail:dr_ahmet_bekar@hotmail.com

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