The Impact of the Use of Neuronavigation Together with Intraoperative Ultrasonography In Minimally Invasive Intracranial Cavernous Hemangioma Surgery

Abstract

Objective: To investigate the contribution of the use of neuronavigation together with intraoperative ultrasonography in the surgical treatment of cavernous hemangiomas to the decrease of mortality and morbidity. Materials and Methods: A total of 73 cases with cavernous hemangiomas, operated on under the guidance of neuronavigation and intraoperative ultrasonography between June 2000 and September 2010 in the Neurosurgery Department of the University of Erciyes, were investigated retrospectively. The cases were evaluated from the point of neurological deterioration due to surgery. Results: The lesions were mostly located supratentorially, especially in the temporal region. The most common complaint of supratentorially located lesions was epilepsy. Such findings and symptoms as bleeding, headache, and focal neurological deficits were observed mostly in the lesions of infratentorial region; 80 cavernous hemangiomas in 73 cases were removed in total. In 3 of the cases, a temporary increase in the neurological deficits was observed; however, in the late periods, no persistent morbidity or mortality due to surgery was observed. Conclusion: By using neuronavigation together with intraoperative ultrasonography, the inconsistency between real location and the navigation image of the lesion resulting from the brain shift due to cerebrospinal fluid drainage can be restored; so, the morbidity and mortality can be decreased.