gms | German Medical Science

Objective: To achieve an optimal neuronavigation-assisted accuracy for resection of cerebral deep-seated pathologies such as cavernous haemangiomas is sometimes known to be difficult. The goal of the present clinical study was to evaluate the feasibility, accuracy, efficacy and safety of a stereotaxy-guided resection for patients suffering from deep-seated cavernous haemangiomas.

Methods: In the present preliminary series a total of 10 patients with intracranial cavernous haemangiomas were integrated in the study. From all patient an informed consent was obtained. In this patient population 8 patients suffered from preoperative seizures whereas a bleeding was documented in 5 patients. The definition of a deep cavernous haemangioma was more than 2 cm subcortical. Preoperative planning comprised a magnetic resonance imaging (MRI) and a computerized tomography (CT).

Results: In all patients the Riechert Mundinger frame system was positioned in advance of the planning CT. In a second step the MRI and CT data were fused using fusion software (Brainlab, Germany). Based on this fusion image the entry and target point as well as the trajectory were calculated. In all patients the entry point was positioned within one sulcus whereas the target point was positioned at the equator line of the pathology. Intraoperatively a mini-craniotomy was performed followed by positioning of the stereotactic needle. Following this needle position in situ the cavernous haemangioma was directly localized and completely resected in all patients. There was no postoperative event such as for example a bleeding or infection.

Conclusions: Stereotaxy guided minimal invasive resection of deep seated cavernous haemangiomas is a highly accurate and effective surgical technique. Furthermore as documented in this first clinical series the technique was not related with any side effects such as bleeding or infection.