Diffusion tensor-based fiber tracking and intraoperative neuronavigation for the resection of a brainstem cavernous angioma.
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.
Chen
Xiaolei
X
Department of Neurosurgery, University of Erlangen-Nürnberg, 91054 Erlangen, Germany. xiaolei.chen@nch.imed.uni-erlangen.de
Weigel
Daniel
D
Ganslandt
Oliver
O
Fahlbusch
Rudolf
R
Buchfelder
Michael
M
Nimsky
Christopher
C
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*