CT angiographic-guided frameless stereotactic-assisted clipping of a distal posterior inferior cerebellar artery aneurysm: technical case report.
BACKGROUND
The development of frameless stereotaxis allows for repetitive intraoperative localization with millimeter accuracy. High-resolution computed tomographic (CT) angiography provides multiplanar, three-dimensional imaging of cerebral vascular lesions. The image data set generated during CT angiography can be used for localization in frameless stereotaxis when performed with appropriate fiducials in place.


METHODS
The feasibility of melding these two technologies was tested on a patient with a small (5 mm), distal ruptured posterior inferior cerebellar artery aneurysm, which was visualized by CT angiography and localized by frameless stereotaxis.


RESULTS
Visualization by CT angiography and intraoperative localization by frameless stereotaxis were successful.


CONCLUSIONS
The practical application of this technology meld is demonstrated in this sample case. Applications to distal anterior cerebral artery aneurysms, abnormal flow-related aneurysms associated with arteriovenous malformations, and mycotic aneurysms are discussed.
Origitano
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TC
Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Anderson
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DE
D000792:Angiography / Q000379:methods; D001158:Arteries / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply*; D003399:Craniotomy; D004867:Equipment Design; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods