title: Usefulness of Preoperative Surgical Simulation with Three-Dimensional Fusion Images for Resection of Cerebral Cavernous Malformations Near Broca's Area.
abstract: Treating subcortical brain lesions in or near eloquent areas is challenging not only because lesions must be resected while preserving brain tissue involved in essential functions, but also because lesions often cannot be easily identified from the surface of the brain. Here, we report 2 cases of cerebral cavernous malformations near Broca's area. In both cases, lesions were surgically removed by utilizing three-dimensional fusion images created using preoperative magnetic resonance imaging and computed tomography data. Excisions were completed without any worsening of speech function, and the use of presurgical simulations was found to be useful in the design and execution of the actual operations. The technique described in this report serves as a useful tool in simulating surgical strategies by using brain gyri and sulci as surgical landmarks. Furthermore, in contrast to other intraoperative techniques, this method can aid in shortening the duration of surgery and can help limit damage to eloquent areas of the brain.
authors.affiliation: Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohta-machi 366, Gunma, Isesaki 372-0006, Japan.
authors.forename: Satoshi
authors.identifier: 0000-0002-0168-1261
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohta-machi 366, Gunma, Isesaki 372-0006, Japan.
authors.forename: Yoshio
authors.identifier: 0000-0002-2165-1342
authors.initials: Y
authors.lastname: Tanizaki
authors.affiliation: Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohta-machi 366, Gunma, Isesaki 372-0006, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Akaji
authors.affiliation: Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohta-machi 366, Gunma, Isesaki 372-0006, Japan.
authors.forename: Tadashige
authors.initials: T
authors.lastname: Kano
authors.affiliation: Hiraga Neurosurgical Clinic, Gunma, Tamamura 370-1124, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hiraga
authors.affiliation: Department of Neurology, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Gunma, Isesaki 372-0006, Japan.
authors.forename: Ban
authors.identifier: 0000-0002-4613-3090
authors.initials: B
authors.lastname: Mihara