title: The use of indocyanine green videoangiography to optimize the dural opening for intracranial parasagittal lesions.
abstract: BACKGROUND
  We describe our clinical experience with the use of indocyanine green (ICG) videoangiography to delineate the locations of the cortical draining veins before dural opening in 3 cases of parasagittal lesions. With this technique, the veins are marked through the dura, and then the dura can be opened precisely to avoid cortical venous injury.
  
  
  OBJECTIVE
  To demonstrate in a clinical series the adjunct use of intraoperative ICG angiography to optimize the dural opening for parasagittal lesions.
  
  
  METHODS
  We describe 3 cases of parasagittal lesions, 2 meningiomas, and 1 arteriovenous malformation treated using the described technique.
  
  
  RESULTS
  Once the dura had been exposed, ICG at a dose of 0.25 mg/kg was injected into the patient's peripheral vein as a bolus. When the dye reached the illuminated field of interest, ICG fluorescence was induced by the use of a light source with a wave-length ICG absorption band. Thereafter, the dural cortical veins were marked through the dura and precisely opened, avoiding cortical venous injury.
  
  
  CONCLUSIONS
  Indocyanine green video angiography is a safe, fast, inexpensive, and accurate investigation that allows the surgeon to strategically plan and protect important parasagittal dural venous drainage during craniotomy.
authors.affiliation: National Brain Aneurysm Center, St. Joseph's Hospital, St. Paul, Minnesota, USA. LNUSSBAUM@comcast.net
authors.forename: Eric S
authors.initials: ES
authors.lastname: Nussbaum
authors.forename: Archie
authors.initials: A
authors.lastname: Defillo
authors.forename: Leslie
authors.initials: L
authors.lastname: Nussbaum
mesh_terms: D000368:Aged; D002550:Cerebral Veins / Q000601:surgery; D004396:Coloring Agents; D003392:Cranial Sinuses / Q000601:surgery; D003399:Craniotomy / Q000379:methods*; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D007208:Indocyanine Green; D007431:Intraoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D014741:Video Recording / Q000379:methods*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green