min - Minimally Invasive Neurosurgery, Table of Contents Minim Invasive Neurosurg 2006; 49(6): 357-358DOI: 10.1055/s-2006-961819 Original Article © Georg Thieme Verlag KG · Stuttgart · New YorkTracing the Dural Tail with Image-Guided SurgeryS. Keskil 1 , G. Bademci 2 , M. Goksel 3 1Department of Neurosurgery, Bayindir Medical Center Sogütözü, Ankara, Turkey 2Department of Neurosurgery, Faculty of Medicine, University of Kirikkale, Kirikkale, Turkey 3Department of Neurosurgery, Bayindir Medical Center Kavaklidere, Ankara, Turkey Recommend Article Abstract Buy Article Abstract Objective: The extent of dural resection is important for preventing recurrence in meningioma management. An image-guidance assisted technique is described to perform adequate dural resection. Methods: A universal instrument adapter system for image-guidance was used to track the dural extension of the meningioma accurately. Results: The universal instrument adapter offers the surgeon the possibility to image-guide nearly any rigid instrument via the computed calibration method. In this way a surgical marking pen was used to chase and adequately mark the “dural tail”. Discussion: Image-guidance systems can be used to avoid incomplete resection of the affected dura that may be responsible for tumour recurrence. Key words Dural tail - tumour - neuronavigation - recurrence Full Text References References 1 Wilms G, Lammens M, Marchal G, Van Calenbergh F, Plets C, Van Fraeyenhaven L, Baert AL. Thickening of dura surrounding meningiomas: MR features. J Comput Assist Tomogr. 1989; 13 763-768 2 Wallace EW. The dural tail sign. Radiology. 2004; 233 56-57 3 Goldsher D, Litt AW, Pinto RS, Bannon KR, Kricheff II. Dural tail associated with meningiomas on Gd-DTPA-enhanced MR images: characteristics, differential diagnostic value, and possible implications for treatment. Radiology. 1990; 176 447-450 4 Aoki S, Sasaki Y, Machida T, Tanioka H. Contrast-enhanced MR images in patients with meningioma: importance of enhancement of the dura adjacent to the tumour. AJNR Am J Neuroradiol. 1990; 11 935-938 5 Whittle IR, Smith C, Navoo P, Collie D. Meningiomas. The Lancet. 2004; 363 1535-1543 6 Gupta S, Gupta RK, Banerjee P, Gujral RB. Problems with the dural tail. Neuroradiology. 1993; 35 541-542 7 Lunardi P, Mastronardi L, Nardacci B, Acqui M, Fortuna A. Dural tail adjacent to acoustic neuroma on MRI: a case report. Neuroradiology. 1993; 35 270-271 8 Senegor M. Prominent meningeal tail sign in a patient with a metastatic tumour. Neurosurgery. 1991; 29 294-296 9 Bourekas EC, Wildenhain P, Lewin JS, Tarr RW, Dastur KJ, Raji MR, Lanzieri CF. The dural tail sign revisited. AJNR Am J Neuroradiol. 1995; 16 1514-1516 10 Nagele T, Peterson D, Klose U, Grodd W, Opitz H, Voigt K. The dural tail adjacent to meningiomas studied by dynamic contrast-enhanced MRI: a comparison with histopathology. Neuroradiology. 1994; 36 303-307 11 Kawahara Y, Niiro M, Yokohama S, Kuratsu J. Dural congestion accompanying meningioma invasion into vessels: the dural tail sign. Neuroradiology. 2001; 43 462-465 12 Tokumaru A, O’uchi T, Eguchi T, Kawamoto S, Kokubo T, Suzuki M, Kameda T. Prominent meningeal enhancement adjacent to meningioma on Gd-DTPA-enhanced MR images: histopathologic correlation. Radiology. 1990; 175 431-433 13 Simpson D. The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiat. 1957; 20 22-39 , (Cited in reference [5]) 14 Mirimanoff RO, Dosoretz DE, Linggood RM, Ojemann RG, Martuza RL. Meningioma: analysis of recurrence and progression following neurosurgical resection. J Neurosurg. 1985; 62 18-24 15 Nakau H, Miyazawa T, Tamai S, Tsuchiya K, Shima K, Shirotani T, Chigasaki H. Pathologic significance of meningeal enhancement (flare sign) of meningiomas on MRI. Surg Neurol. 1997; 48 584-591 16 DiBiase SJ, Kwok Y, Yovino S, Arena C, Naqvi S, Temple S, Regine WF, Amin P, Guo C, Chin LS. Factors predicting local tumour control after gamma knife stereotactic radiosurgery for benign intracranial meningiomas. Int J Radiat Oncol Biol Phys. 2004; 60 1515-1519 17 Borowich B, Doron Y. Recurrence of intracranial meningiomas: the role played by regional multicentricity. J Neurosurg. 1986; 64 58-63 Correspondence Prof. Dr. Semih Keskil Fethiye Sokak Ozbek apt. No: 4/6 Gazi Osman Pasa 06700 Ankara Turkey Phone: +90/532/615 84 22 Fax: +90/312/284 42 77 Email: sk06-k@tr.net