Virtual and Augmented Reality in Neurosurgery.

In this chapter, we explore the role of mixed reality (MxR), a synergy of virtual reality (VR) and augmented reality (AR), in neurosurgery. MxR marks a significant advancement in surgical planning and execution, enhancing precision, safety, and outcomes. We trace the evolution of neurosurgical techniques, positioning MxR as the latest innovation in a series of technological advancements aimed at improving surgical accuracy and patient safety.The chapter details VR's role in providing immersive preoperative environments for detailed surgical rehearsal, utilizing 3D reconstructions of patient-specific neuroanatomy. AR complements this by overlaying critical digital information onto the surgeon's real-time view, thus reducing cognitive load and enhancing focus during critical surgical phases.We specifically highlight MxR's application in brain tumor and skull base surgery, demonstrating its capacity to facilitate meticulous planning and navigation through complex anatomical structures. The chapter includes case studies illustrating MxR's effectiveness in cerebrovascular surgeries, such as arteriovenous malformations (AVM) and aneurysm treatments, and discusses its potential in neurosurgical training and custom implant design.Concluding with a discussion of the challenges in MxR adoption and future perspectives, the chapter underscores MxR's potential to revolutionize neurosurgical interventions, making them safer, more efficient, and tailored to individual patient needs.