Using the Magnetic Resonance Three-Dimensional Volume Rendering for Tissues Technique in the Planning of Craniotomy Flaps with Linear Scalp Incision

Aydın, Keramettin; Çokluk, Cengiz; Kuruoğlu, Enis; Gelmez, Serkan; Diren, B.; Rakunt, C.; Çelik, Fahrettin

doi:10.1055/s-2006-948300

Cited by 11 publications

(10 citation statements)

References 18 publications

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“…5C), which were frequently used until recently. 3,10 In contrast, doubletype procedures, which we defined as those that harvest both the temporal and frontal branches of the STA, are considered to reduce the blood supply to the scalp in a critical way (Fig. 5D).…”

Section: Discussionmentioning

confidence: 99%

Operative wound-related complications after cranial revascularization surgeries

Takanari

Araki²,

Okamoto³

et al. 2015

JNS

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aBBreViatiONS BA = basilar artery; DM = diabetes mellitus; EDAMS = encephalo-duro-arterio-myo-synangiosis; EDAS = encephalo-duro-arterio-synangiosis; EMS = encephalo-myo-synangiosis; ICA = internal carotid artery; MCA = middle cerebral artery; MMD = moyamoya disease; SCA = superior cerebral artery; SPECT = singlephoton emission computed tomography; STA = superficial temporal artery; STSG = split-thickness skin graft. SuBmitted January 13, 2014. accepted December 5, 2014. iNclude wheN citiNg Published online July 3, 2015; DOI: 10.3171/2014.12.JNS132602. diSclOSure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. * Drs. Takanari and Araki contributed equally to this work. OBJect Intracranial revascularization surgeries are an effective treatment for moyamoya disease and other intracranial vascular obliterative diseases. However, in some cases, wound-related complications develop after surgery. Although the incidence of wound complication is supposed to be higher than that with a usual craniotomy, this complication has rarely been the focus of studies in the literature that report the outcomes of revascularization surgeries. Here, the relationship between intracranial revascularization surgeries and their complications is statistically assessed. . Multivariate logistic regression analysis also revealed that double procedures demonstrated a significantly higher incidence of wound complications than single procedures (OR 3.087, p = 0.048). DM was found to be a risk factor for wound complication (OR 9.42, p = 0.02), but age, sex, hypertension, and hyperlipidemia were not associated with the incidence of complications. Even though the blood supply to the scalp is abundant due to 5 arteriovenous systems, sometimes cutaneous necrosis develops after intracranial revascularization surgeries. The galeal blood supply is thought to be crucial for preventing wound-related complications. Special care is also thought to be required for DM patients. cONcluSiONS Revascularization surgeries seemed to demonstrate a higher risk of wound-related complications. Double-type procedures, which use both branches of the STA, and a history of DM were found to be risk factors for wound-related complications. Attention should be paid to the design of the galeal incision and vessel harvest line. Also, special attention should be paid to patients with DM.http://thejns.org/doi/abs/10.3171/2014.12.JNS132602KeY wOrdS cranial revascularization surgery; extracranial to intracranial bypass; infection; skin necrosis; superficial temporal artery-to-middle cerebral artery anastomosis; wound-related complication; vascular disorders 1145

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Section: Discussionmentioning

confidence: 99%

Operative wound-related complications after cranial revascularization surgeries

Takanari

Araki²,

Okamoto³

et al. 2015

JNS

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“…Their processing steps included extraction of the brain by paintbrush, VR reconstruction of the brain, extraction of the blood vessels and tumor, respectively, and final combining of all images. Aydin et al [3] made 3D images of the surface venous anatomy from post-contrast time-of-flight sequence raw data. However, surgical findings correlated well with the 3D VR images in only 45% patients according to their experience.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, superficial cerebral veins (SCVs) can be important landmarks in neurosurgery. Therefore, preoperative mapping of the SCVs and their relationships with brain surface structures and tumors is helpful for the planning of a linear scalp incision and the opening site of dura mater to protect SCVs during surgical dissection and to find the splitting site of the brain according to the lesion [1,3] .…”

Section: Introductionmentioning

confidence: 99%

Virtually Peeling Off the Skull and Scalp: A Simple Way of Mapping the Superficial Cerebral Veins on the Brain Surface

Gong¹,

Higano²,

Mugikura³

et al. 2008

Stereotact Funct Neurosurg

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Purpose: A simple MRI postprocessing technique was developed to display superficial cerebral veins (SCVs) along with brain surface structures. Materials and Methods: Thirty-one consecutive patients with brain tumors were studied. All patients underwent brain MR examination, from which three-dimensional (3D) images were reconstructed. Simulation images of craniotomy were created by cutting away the signal from the skull and scalp at the region corresponding to the window planned for surgery. Detectability of the SCVs was evaluated by comparing the simulation images with intraoperative photographs. Reasons for those undetectable SCVs on simulation images of craniotomy were discussed. Results: Detectability of the SCVs >2 mm was 100%; those from 1 to 2 mm was 88.5%, and those from 0.5 to 1 mm 56.9%. Effacement of cortical sulci/subarachnoid space around the supposed craniotomy site, dural/meningeal contrast enhancement and insufficient spatial resolution of the source images were regarded as the main reasons for undetectable SCVs. Conclusion: Virtually peeling off the skull and scalp well demonstrates the SCVs along with brain surface structures. This simple technique can provide useful information about the SCVs and their relationships with cortical structures and tumors for preoperative surgical planning.

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“…We explored and evaluated the reliability of a different model of intraoperative orientation by using the MRIcro image processing software, downloadable from the Internet as one of the programs currently available, free of charge, for volumetric reconstruction of MR images. 12,22 Our proposed technique relies on a detailed planning of the surgical procedure based on the individual anatomy. The planning is performed anytime before surgery and therefore does not affect the length of the operative session.…”

Section: Discussionmentioning

confidence: 99%

Frameless Nonstereotactic Image-Guided Surgery of Supratentorial Lesions: Introduction to a Safe and Inexpensive Technique

Sherkat

Callovini

Gazzeri

2014

J Neurol Surg A Cent Eur Neurosurg

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The lesions were accessed through an optimally suited craniotomy. The visual matching of the cortical surface with reconstructed 3D images of the cortex permitted a fast localization of cortical and subcortical lesions. The major limitation is the depth of a lesion deeper than 3 cm. In these cases, the use of frame-based or frameless techniques still seems safer and more advantageous. Conclusions: The shape recognition of the cortical landmarks was not biased by brain distortion because the sulci and cortical vessels almost always had a relationship to each other that was not modified by edema or cerebrospinal fluid leakage. This 3DR allows us to reconstruct a virtual anatomy in an easy, portable, and inexpensive way. In selected cases, this technique represents a valid and safe alternative to the use of costly neuronavigation tools and is potentially helpful in developing countries.

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Using the Magnetic Resonance Three-Dimensional Volume Rendering for Tissues Technique in the Planning of Craniotomy Flaps with Linear Scalp Incision

Cited by 11 publications

References 18 publications

Operative wound-related complications after cranial revascularization surgeries

Operative wound-related complications after cranial revascularization surgeries

Virtually Peeling Off the Skull and Scalp: A Simple Way of Mapping the Superficial Cerebral Veins on the Brain Surface

Frameless Nonstereotactic Image-Guided Surgery of Supratentorial Lesions: Introduction to a Safe and Inexpensive Technique

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