title: Scalp marking for a craniotomy using a laser pointer during preoperative computed tomographic imaging: technical note.
abstract: OBJECTIVE
  The preoperative localization of superficial intracranial lesions is often necessary for accurate burr hole placement or craniotomy siting. It is not always easy, however, to localize the lesions over the scalp working only from computed tomographic images. We developed a simple method for such localization using a laser pointer during the preoperative computed tomographic examination.
  
  
  METHODS
  The angle of incidence, extending from a point on the scalp to the center of the computed tomographic image, is measured by the software included with the scanner. In the gantry, at the same angle as on the image, a laser is beamed from a handmade projector onto the patient's scalp toward the center of the gantry. The point illuminated on the patient's head corresponds to that on the image. The device and the method are described in detail herein.
  
  
  RESULTS
  We applied this technique to mark the area for the craniotomy before surgery in five patients with superficial brain tumors. At the time of surgery, it was confirmed that the tumors were circumscribed precisely.
  
  
  CONCLUSIONS
  The technique is easy to perform and useful in the preoperative planning for a craniotomy. In addition, the device is easily constructed and inexpensive.
authors.affiliation: Department of Neurosurgery, Takarazuka Municipal Hospital, Hyogo, Japan. sig-kubo@momo.so-net.ne.jp
authors.forename: S
authors.initials: S
authors.lastname: Kubo
authors.forename: H
authors.initials: H
authors.lastname: Nakata
authors.forename: Y
authors.initials: Y
authors.lastname: Sugauchi
authors.forename: N
authors.initials: N
authors.lastname: Yokota
authors.forename: T
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D003399:Craniotomy / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D007834:Lasers; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D008579:Meningioma / Q000000981:diagnostic imaging / Q000601:surgery; D008953:Models, Anatomic; D012984:Software; D013238:Stereotaxic Techniques / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*