gms | German Medical Science

59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle

Nutzen der Neuronavigation für den kontralateralen interhemisphärischen Zugang zum Seitenventrikel

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  • corresponding author C. Fronda - Division of Neurosurgery, Department of Neuroscience, University of Torino, Torino, Italy
  • D. Miller - Department of Neurosurgery, Philipps University Clinic, Marburg, Germany
  • C. Kappus - Department of Neurosurgery, Philipps University Clinic, Marburg, Germany
  • H. Bertalanffy - Department of Neurosurgery, Universitätsspital Zürich, Zürich, Switzerland
  • U. Sure - Department of Neurosurgery, Philipps University Clinic, Marburg, Germany

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 020

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc288.shtml

Published: May 30, 2008

© 2008 Fronda et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image guided transcallosal approach.

Methods: Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image guided system (VectorVision2, BrainLAB, Heimstetten, Germany) directed (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum.

Results: Using the image guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without risk to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2 - 2.1 cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series.

Conclusions: Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.