title: CT-guided stereotactic neurosurgery using the Brown-Roberts-Wells system: experience with 125 procedures.
abstract: Experience with a consecutive series of 125 computerized tomographic (CT) image guided stereotaxic neurosurgical procedures, performed using the Brown-Roberts-Wells (BRW) system is described. Operative objectives included tissue sampling for diagnostic purposes, intra-operative localization of craniotomy flaps and intracerebral lesions, cyst and abscess aspiration and lesion to modulate tremor. A neuropathological diagnosis was possible in 96% of the biopsies, and lesions were precisely localized in all patients undergoing microsurgical stereotaxic craniotomy. Two patients (2.2%) undergoing stereotaxic biopsy died as a result of the procedure and one patient's hemiparesis was permanently worsened (0.8%). In only one of three patients undergoing stereotaxic thalamotomy was tremor abolished. This report confirms that CT image guided stereotaxic neurosurgery is safe, accurate and versatile. There is, however, a moderate incidence (7.2%) of lesser complications that can occur with this type of surgery. These complications, which are emphasized in this paper, are related to both the site of surgery and the neuropathology.
authors.affiliation: Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland.
authors.forename: I R
authors.initials: IR
authors.lastname: Whittle
authors.forename: S W
authors.initials: SW
authors.lastname: Denholm
authors.forename: K
authors.initials: K
authors.lastname: Elshunnar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001922:Brain Abscess / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000209:etiology; D002648:Child; D003399:Craniotomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D013238:Stereotaxic Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013788:Thalamus / Q000601:surgery; D014057:Tomography, X-Ray Computed