title: Diffusion tensor-based fiber tracking and intraoperative neuronavigation for the resection of a brainstem cavernous angioma.
abstract: BACKGROUND
  Surgical treatment of brainstem cavernous angioma involving eloquent fiber tracts is one of the most challenging areas of contemporary neurosurgery. Diffusion tensor imaging-based fiber tracking adds essential information for preoperative planning in neurosurgical practice. Integration of the tractography into neuronavigation system makes it possible for the intraoperative visualization of the major fiber tracts. It may help increase the likelihood of the total resection of tumors adjacent to the eloquent fiber tracts and avoid new neurologic deficits after surgery.
  
  
  METHODS
  We report our valuable experience of such integration for the resection of a deeply located brainstem cavernous angioma.
  
  
  CONCLUSIONS
  Inclusion of tractography in standard imaging protocols for neuronavigation systems can provide important information regarding neural tracts for the planning of brainstem surgery. It can also increase the safety of neurosurgical intervention near white matter tracts in the brainstem.
authors.affiliation: Department of Neurosurgery, University of Erlangen-Nürnberg, 91054 Erlangen, Germany. xiaolei.chen@nch.imed.uni-erlangen.de
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Chen
authors.forename: Daniel
authors.initials: D
authors.lastname: Weigel
authors.forename: Oliver
authors.initials: O
authors.lastname: Ganslandt
authors.forename: Rudolf
authors.initials: R
authors.lastname: Fahlbusch
authors.forename: Michael
authors.initials: M
authors.lastname: Buchfelder
authors.forename: Christopher
authors.initials: C
authors.lastname: Nimsky
mesh_terms: D000368:Aged; D020295:Brain Stem Neoplasms / Q000473:pathology / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000473:pathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D038361:Neuronavigation / Q000379:methods*; D011712:Pyramidal Tracts / Q000473:pathology*