A method for stereotactic coordinate determination by means of X-ray tomography is presented. A standard stereotactic method has been slightly modified, and the localization procedure has been adapted to CT scanning as well as conventional tomography. The technique allows rapid and accurate determination of the instrument coordinates of the target by the surgeon and may be used in conjunction with any standard CT body scanner or X-ray tomograph.
A device is presented that permits several applications for the Leksell stereotaxic system. The patient is fixed in this new system by means of a rectangular instrument that connects to the standard Leksell stereotaxic coordinate frame and maintains spatial orientation after the frame itself is removed. Specific uses for this device include stereotaxic radiosurgery and stereotaxic guidance during microsurgery. Other attractive features of this device are its capability of being precisely reapplied, its compatibility with both computerized tomography and magnetic resonance imaging, and the availability of an accessory device to adapt it for animal stereotaxis.
Two patients with complex partial epilepsy and tumour of the temporal lobe scheduled for gamma knife radiosurgery were evaluated pre- and postoperatively by multichannel magnetoencephalography (MEG). Centers of epileptic dipole activity found preoperatively disappeared after the focal irradiation as did the epileptic seizures. Thus, to combine stereotactic MEG and gamma knife radiosurgery seems to be a non-invasive alternative to the conventional neurosurgery in focal epilepsy.
The necessity for intraoperative computer tomographic (CT) visualization of stereotactic probes and for the immediate assessment of the results of therapeutic intervention has brought about the integration of CT and stereotactic surgical sites. In order to perform intraoperative CT imaging, a simple mechanical device has been developed to hold a probe at the target. This device replaces the conventional semicircular arc that was used to guide the probe to the target during stereotactic procedures. Intraoperative imaging during a CT stereotactic procedure was accomplished without significant artifacts.
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