title: The initial experience with the Cosman-Roberts-Wells stereotactic system.
abstract: The Cosman-Roberts-Wells stereotactic instrument is a recently developed modification, based on an arc-radius design, of the Brown-Roberts-Wells stereotactic frame utilizing the existing fixation and fiducial components of the Brown-Roberts-Wells stereotactic system to localize and verify target data. The design modification has been made with a view to facilitating technical approaches both in stereotactic biopsy and in stereotactic craniotomy, whilst encompassing the same stereotactic space. Initial experience with the Cosman-Roberts-Wells instrument is reported. Over a 5-month period 55 procedures were performed which included 40 stereotactic biopsies, five CT-guided stereotactic craniotomies, three stereotactic placements of a Bennett Ball for thalamotomy, three stereotactic implantations of intracranial electrodes for recording in drug-resistant epilepsy, three aspirations of cyst or haematoma and one implantation of a Gutin catheter for interstitial brachytherapy. There was minimal morbidity and no mortality related to operation. This frame offers rapid targeting without the need to pre-determine entry points, as well as allowing direct lateral passes and unimpeded stereotactic craniotomy.
authors.affiliation: Gough Cooper Department of Neurological Surgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: M F
authors.initials: MF
authors.lastname: Pell
authors.forename: D G
authors.initials: DG
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy / Q000379:methods; D004567:Electrodes, Implanted; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007276:Injections, Intraventricular; D008297:Male; D008722:Methods; D008875:Middle Aged; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed