|
KMID : 1005420050070040293
|
|
Journal of Cerebrovascular and Endovascular Neurosurgery
2005 Volume.7 No. 4 p.293 ~ p.297
|
|
|
Comparison of Image-Guided Surgery Techniques for the Surgical Treatment of Intracerebral Hemorrhage : The Usefulness of Intraoperative Ultrasonography
|
|
Byeon Jae-Hoon
Hong Jae-Taek
Lee Sang-Won
Son Byung-Chul
Sung Jae-Hoon
Kim In-Soo
Choi Hyeon-Cheol
Kim Il-Sup
Kim Moon-Chan
|
|
|
Abstract
|
|
|
Objective: The authors undertook a study to compare three intraoperative guidance systems, which are intraoperative ultrasonography, stereotaxy and computer-assisted image-guided surgery (neuronavigation) in terms of time consuming during the preparation of these procedures. In this operative case-based study, we have investigated the ability and benefits of intraoperative grey-scale sonographic examination in the localizing of intracranial hemorrhage (ICH) in the brain.
Methods: We used B-mode ultrasonography (5-MHz, 1.2x2.5 mm sized probe) during 23 procedures (craniotomy or craniectomy ; 17, hematoma aspiration : 6) performed in the acute stage after head injury, hypertensive ICH, ruptured cerebral aneurysm. Seventeen patients who suffered from spontaneous ICH underwent stereotactic hematoma aspiration and fourteen patients underwent hematoma removal using neuronavigation system (spontaneous ICH ; 11, Arteriovenous malformation and aneurysm ; 3). We compared intraoperative ultrasonography-assisted hematoma removal with procedures with stererotaxy or neuronavigation system in respect of detection of the pathology and time consuming for preparation.
Results: Mean preparation time for stereotactic hematoma aspiration was 71.2 minutes (50-90 minutes), and mean preparation time for neuronavigation-guided surgery was 52.5 minutes (30-70 minutes). However, only 7.4 minutes (4-20 minutes) were needed for the preparation time of intraoperative ultrasonography. Moreover, intraoperative ultrasonography-guided surgery had many advantages compared to other image-guide surgery, such as capability of real-time monitoring and independency of brain shifting. However, there were several limitations too, which were relatively low resolution, artifact by air bubble during the procedure, and the lower echogenecity of liquified hematomas when a delay of several days was needed. Nevertheless, ultrasound-guided hematoma surgery could serve as minimally invasive treatment whenever hematoma evacuation seems to be advisable, at least as a first attempt.
Conclusion: Based on this preliminary result, we concluded that intraoperative ultrasonographic examination during the surgical treatment of ICH was a non-invasive, useful, and simple diagnostic tool in the detection of the components and accompanying parts of the lesion. It was more useful than stereotaxy or neuronavigation system in the situation of emergent case such as an impending brain herniation.
|
|
|
KEYWORD
|
|
|
Intracerebral hemorrhage, Image-guided surgery, Intraoperative ultrasonography
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
 
|
|