A review of perioperative complications during frameless stereotactic surgery: our institutional experience.
OBJECTIVE
Frameless stereotactic neurosurgery is increasingly being used for the biopsy of intracranial tumors and the resection of deep-seated lesions where reliance on surface anatomic landmarks can be misleading, as well as in movement disorders, psychiatric disorders, seizure disorders, and chronic refractory pain. Nascent biological approaches, including gene therapy and stem-cell and tissue transplants for movement disorders, also utilize neuronavigational techniques. These procedures are complex and involve understanding of the basic principles and factors affecting neuronavigation. The procedure may appear to be simple, but serious complications may occur.


METHODS
The purpose of this study was to review the intraoperative and postoperative complications occurring during frameless stereotaxy at our institution from January 2003 to July 2007.


RESULTS
Seventy-eight patients underwent various neurosurgical procedures under general anesthesia. Intraoperative complications seen were intraoperative brain bulge (n = 3), seizures (n = 3), failure to extubate (n = 4), and fresh neurodeficits (n = 6). No hemodynamic disturbances such as hypertension or hypotension or bradycardia or tachycardia requiring active intervention were observed.


CONCLUSIONS
Awareness and vigilance can help in the early identification and better management of the above intraoperative complications.
Ali
Zulfiqar
Z
Department of Neuroanaesthesiology, Neurosciences Center, All India Institute of Medical Sciences, 7th floor, New Delhi 110029, India.
Prabhakar
Hemanshu
H
Bithal
Parmod K
PK
Dash
Hari H
HH
D000328:Adult; D000768:Anesthesia, General; D001922:Brain Abscess / Q000601:surgery; D001929:Brain Edema / Q000453:epidemiology; D001932:Brain Neoplasms / Q000601:surgery; D001986:Bronchial Spasm / Q000139:chemically induced / Q000503:physiopathology; D005260:Female; D015316:Genetic Therapy; D005909:Glioblastoma / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology*; D016634:Radiosurgery; D012640:Seizures / Q000453:epidemiology
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