Application of Stereotactic Concepts to the Surgery of Epilepsy

  • J. Talairach
  • G. Szikla
Part of the Acta Neurochirurgica Supplementum book series (NEUROCHIRURGICA, volume 30)


For the authors, the essential feature of stereotaxis is the three-dimensional representation of the entire brain, including the central gray nuclei as well as the cerebral cortex. Stereotactic neurosurgery, which in this conception might be called “global”, associates data from indirect localization (basic reference lines, proportional grid) to direct individual localization (performed by bidirectional, orthogonal teleradiography, with stereoscopy). The obtained high precision radiographic documents allow to establish the three coordinates (X, Y, Z).

This method, also used in localization of tumours and interstitial irradiation of tumours, led to the definition of a special methodology for epilepsy surgery (threefold correlation of the clinical seizure patterns, electrical anomalies and the concerned anatomical structures). The stereotactic implantation of several acute and chronic electrodes (stereo-EEG) gives a 3-dimensional definition of the epileptogenic area and of its propagation pathways. These data, as well as the individual anatomy of the patient’s brain are represented by the neurosurgeon on a surgical diagram. The transfer of these data to the surgical field is facilitated by the accuracy of the diagram. A double postoperative control is made (photographs—teleangiography).

The described methodology increases the precision of open surgery. It is also used to localize and to remove “incipient” lesions evidenced by the CT scan (accurate anatomical localization—vascularization). In the opinion of the authors, the use of acommon stereotactic geometry applied to the collection of paraclinical data will lead in the future to an increased precision of surgery and hence, to a better respect of the brain and of its function.


Epilepsy Surgery Anterior Choroidal Artery Interstitial Irradiation Stereotactic Neurosurgery Epileptogenic Area 
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  1. 1.
    Bancaud, J., Talairach, J., Bonis, A., Schaub, C., Szikla, G., Morel, P., Bordas-Ferrer, M., La stéréo-électroencéphalographie dans l’epilepsie, 1 vol., 321 p. Paris: Masson. 1965.Google Scholar
  2. 2.
    Bancaud, J., Talairach, J., Geier, S., Scarabin, J. M., EEG et SEEG dans les tumeurs cérébrales et l’épilepsie, 1 vol., 351 p. Paris: Edifor eds. 1973.Google Scholar
  3. 3.
    Pecker, J., Scarabin, J. M., Brucher, J. M., Vallee, B., Démarche stéréotaxique en neurochirurgie tumorale, 1 vol., 301 p. Paris: Laboratoire Fabre. 1979.Google Scholar
  4. 4.
    Pecker, J., Simon, J., Scarabin, J. M., Perfectionnement technique dans le repérage stéréotaxique chez l’homme: étude anatomo-radiologique et traitement de l’information. Premiers résultats. Xe Congrès Int. Neurol. (Barcelone) 1973.Google Scholar
  5. 5.
    Rabischong, P., Vignaud, J., Pardo, P., Thurel, R., Yver, J. P., Stereoradiogrammetry and Angiography. In: Advances in Cerebral Angiography, pp. 141–147 (Salamon, G., ed.). Berlin-Heidelberg-New York: Springer. 1975.Google Scholar
  6. 6.
    Schaltenbrand, G., Bailey, P., Introduction to stereotaxis with an atlas of the human brain, 1 vol. New York: Grüne and Stratton. 1959.Google Scholar
  7. 7.
    Szikla, G., Bouvier, G., Hori, T., In vivo localization of brain sulci by arteriography: a stereotactic anatomoradiological study. Brain Res. 95 (1975), 497–502.PubMedCrossRefGoogle Scholar
  8. 8.
    Szikla, G., Bouvier, G., Hori, T., Petrov, V., Angiography of the Human Brain Cortex. Atlas of Vascular Patterns and Stereotactic Cortical Localization, 1 vol., p. 273. Berlin-Heidelberg-New York: Springer. 1977.Google Scholar
  9. 9.
    Szikla, G., Peragut, J. C., Irradiation interstitielle des gliomes. Neuro-chir. (Paris) 21 (1975), 187–226.Google Scholar
  10. 10.
    Szikla, G., Stereotactic Neuroradiology and Functional Neurosurgery: Localization of Cortical Structures by Three-Dimensional Angiography. In: Functional Neurosurgery (Rasmussen-Marino, ed.). New York: Raven Press. 1979.Google Scholar
  11. 11.
    Talairach, J., Hecaen, H., David, M., Moussier, M., de Ajuriaguerra, J., Recherches sur la coagulation therapeutique des structures souscorticales chez l’homme. Rev. Neurol. (Paris) 81 (1949), 4–24.Google Scholar
  12. 12.
    Talairach, J., de Ajuriaguerra, J., David, M., Etudes stéréotaxiques et structures encéphaliques profondes chez l’homme. Presse Méd. (Paris) 28 (1952), 605–609.Google Scholar
  13. 13.
    Talairach, J., Aboulker, J., Ruggiero, G., David, M., Utilisation de la méthode radio-stéréotaxique pour le traitement radioactif in situ de tumeurs cérébrales. Rev. Neurol. (Paris) 90 (1954), 656–657.Google Scholar
  14. 14.
    Talairach, J., Les explorations radiologiques stéréotaxiques. In: Les explora- tions radiologiques en neurochirurgie cérébrale, pp. 124–152 (David, M., ed.). Paris: Masson. 1954.Google Scholar
  15. 15.
    Talairach, J., Ruggiero, G., David, M., The roentgenologic contribution to stereotaxic investigations of the brain and its practical application in pathologic conditions. Acta Radiol. (Stockholm) 46 (1956), 391–406.Google Scholar
  16. 16.
    Talairach, J., David, M., Tournoux, P., et al., Atlas d’Anatomie stéréotaxique, 1 vol., 294 p. Paris: Masson. 1957.Google Scholar
  17. 17.
    Talairach, J., Tournoux, P., Chirurgie stéréotaxique. In: Traité de Technique Chirurgieale, T3–1, pp. 358–435. Paris: Masson.Google Scholar
  18. 18.
    Talairach, J., Szikla, G., Tournoux, P., Prossalentis, A., Bordas-Ferer, M., Covello, L., Iacob, M., Mempel, E., Atlas d’anatomie stéréotaxique du téléencéphale—Atlas of stereotactic anatomy of the telencephalon, 1 vol., 323 p. Paris: Masson. 1967.Google Scholar
  19. 19.
    Talairach, J., Bancaud, J., Approche nouvelle de la neurochirurgie de l’épilepsie. Méthodologie stéréotaxique et résultats thérapeutiques. Neurochir. (Paris) 20, suppl. 1 (1974), 240 p.Google Scholar
  20. 20.
    Talairach, J., Peragut, J. C., Farnarier, Ph., Manrique, M., The Role of the Stereotaxic Radiographic Exploration in the Neurosurgical Intervention. In: Advances in Cerebral Angiography, pp. 215–261 (Salamon, G., ed.). Berlin- Heidelberg-New York: Springer. 1975.Google Scholar
  21. 21.
    Talairach, J., Szikla, G., Stereotactic Neuroradiological Concepts Applied to Surgical Removal of Cortical Epileptogenic Areas. Functional Neurosurgery, pp. 219–242 (Rasmussen-Marino, ed.). New-York: Raven Press. 1979.Google Scholar

Copyright information

© Springer-Verlag 1980

Authors and Affiliations

  • J. Talairach
    • 1
  • G. Szikla
    • 2
  1. 1.Fonctionnelle du Centre Hospitalier Sainte-AnneParis, Cedex 14France
  2. 2.Service de Neurochirurgie FonctionnelleDu Centre Hospitalier Sainte-AnneParis, Cedex 14France

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