Surgical management of eloquent supratentorial low-grade gliomas with special emphasis on intraoperative imaging.

Objective: Eloquent diffuse low-grade gliomas (LGGs) threaten patients' neurologic function and are also associated with inferior survival. Many neurosurgeons still refrain from early resection due to the fear of iatrogenic neurologic injury. However, the perceived safety of expectant management strategies may soon be overshadowed by the progressive deficits of tumor growth in eloquent regions.

Model-based correction of velocity measurements in navigated 3-D ultrasound imaging during neurosurgical interventions.

In neurosurgery, information of blood flow is important to identify and avoid damage to important vessels. Three-dimensional intraoperative ultrasound color-Doppler imaging has proven useful in this respect. However, due to Doppler angle-dependencies and the complexity of the vascular architecture, clinical valuable 3-D information of flow direction and velocity is currently not available.

Blood flow imaging: an angle-independent ultrasound modality for intraoperative assessment of flow dynamics in neurovascular surgery.

Objective: The objective of this study was to investigate the clinical applicability of navigated blood flow imaging (BFI) in neurovascular applications. BFI is a new 2-dimensional ultrasound modality that offers angle-independent visualization of flow. When integrated with 3-dimensional (3D) navigation technology, BFI can be considered as a first step toward the ideal tool for surgical needs: a real-time, high-resolution, 3D visualization that properly portrays both vessel geometry and flow direction.

Tissue motion and strain in the human brain assessed by intraoperative ultrasound in glioma patients.

The objective of the study was to investigate tissue motion and strain imposed by cardiovascular pulsation in pathologic and normal brain parenchyma, as quantified from in vivo ultrasound data. Ultrasound acquired during surgery of 16 patients with glial tumors was retrospectively processed and analyzed. The tissue velocity was quantified at depths of 1cm, 2cm and 3cm from brain cortex to investigate spatial dependency with depth.

Integrated pre- and intraoperative imaging in a patient with an arteriovenous malformation located in eloquent cortex.

Introduction: The use of integrated pre- and intraoperative imaging may be useful when resecting brain lesions in close proximity to eloquent areas, such as the primary motor cortex and language cortices.

Case Report: A 32-year-old woman with an arteriovenous malformation (AVM) located in the primary motor cortex underwent surgery using functional neuronavigation. Blood-oxygenation-level-dependent functional magnetic resonance imaging (BOLD fMRI) and diffusion tensor tractography (DTT) were used for preoperative mapping of primary motor areas and the corticospinal tracts, respectively.