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Consideration of Intraoperative Brain Shift for Frameless Stereotaxy

  • Hiroshi Okudera
  • Shigeaki Kobayashi
  • Hisashi Nagashima
  • Toru Koyama
  • Susumu Oikawa
Conference paper

Summary

Brain shift during open neurosurgery is a major factor causing errors in intraoperative neuronavigation based on preoperative neuroradiological images. Under the observation of intraoperative CT images provided by the operating CT scanner system in Shinshu University Hospital, the causes of intraoperative brain shift were analyzed. As direct surgical factors of intraoperative brain shift, decompressive effects by craniotomy, dural opening, and suction of cerebrospinal fluid may play a significant role on intraoperative shift. Also, surgical procedures including brain retraction and dissection significantly affect intraoperative CT findings. Furthermore, changes of brain volume by administration of anesthetic and osmotic agents and intraoperative management of respiration and blood pressure may be important indirect factors in intraoperative brain shift affecting neuronavigation.

Key words

Navigation Image-guided surgery (IGS) Computer-assisted surgery Frameless stereotaxy Intraoperative CT scanning Brain shift Open neurosurgery 

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Copyright information

© Springer-Verlag Tokyo 1997

Authors and Affiliations

  • Hiroshi Okudera
    • 1
  • Shigeaki Kobayashi
    • 1
  • Hisashi Nagashima
    • 1
  • Toru Koyama
    • 1
  • Susumu Oikawa
    • 1
  1. 1.Department of NeurosurgeryShinshu University School of MedicineMatsumoto, Nagano 390Japan

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