Use of highend ultrasound in minimally invasive strategy of neurosurgery: Review of 1090 cases

The purpose of this study is to present our routine use of high-end ultrasound technique in neurosurgery. The ALOKA 5000 with four small probes offered a basis to improve minimally invasiveness in our discipline: TCD probe (2.14 to 3.75MHZ) was used in 560 cases mainly at ICU; the small part sector probe (3.8 to 7.5MHZ) was mainly applied intra-operatively in 195 cases and the burr hole probe (3.75 to 7.5MHZ) was also mainly used intra-operatively in 92 cases. The trans-endoscopic mini-probe (360°, 6F + 8F, 10, 15, 20MHZ) was used with strictly indication integrated into high-end machine in 21 cases (out of over100 cases). The complete spectrum of neurosurgical diagnoses presented applicable assistance for therapy in our experience. In 279 intra-operative applications ultrasound proved to be an excellent neuro – navigation system providing the surgeon with real-time imaging and targeting capabilities. Resection control in 55 tumor cases with targeting in 34 small lesions was very satisfying and in four cases craniotomy correction was possible before opening of dura mater. Compensation of computer-navigation failures was possible in 14 cases preventing possible disasters. The 528 cases of application at the ICU showed a bedside use, resulting in decrease of risky out door examination reduce stress for our patients and logistic efforts for the professionals.

Ultrasound proved to be an excellent tool peri- and intra-operative to realize minimally invasive strategies in neurosurgery.