Interactive computer graphic image analysis for functional neurosurgery.

This study deals with the use of microcomputer graphic analysis of preoperative magnetic resonance imaging (MRI) scans in functional neurosurgical procedures. Three patients (2 treated for thalamotomy and 1 for thalamic stimulation) had preadmission MRI scans which delineated the classic internal landmarks used in functional neurosurgery. These data were then manipulated and stored using a microcomputer-based graphic analysis system. Intraoperative pattern matching of preadmission graphics with the intraoperative skull X-rays allowed determination of the planned target in the x, y and z coordinates. The accuracy of the graphics FM-PC and AC-PC points was confirmed with the use of ventriculography, stimulation, and postoperative MRI scans. This simple, inexpensive method obviates the need for ventriculography, sedation, intraoperative MRI with a scan-compatible frame, and has the accuracy necessary for functional procedures.