The first evaluation of brain shift during functional neurosurgery by deformation field analysis
- 1Department of Neurosurgery, University of Leipzig, Leipzig, Germany
- 2Max-Planck-Institut for Neurocognition and Neuroscience, Leipzig, Germany
- 3Department of Neurology, University of Leipzig
- Correspondence to: Dr Dirk Winkler Klinik für Neurochirurgie, Universität Leipzig, Liebigstr 20, 04103 Leipzig, Germany; windmedizin.uni-leipzig.de
- Received 9 June 2004
- Accepted 15 December 2004
- Revised 11 October 2004
Abstract
Stereotactic surgery is based on a high degree of accuracy in defining and localising intracranial targets and placing surgical tools. Brain shift can influence its accuracy significantly. Deep brain stimulation of the subthalamic nucleus can markedly change the quality of life of patients with advanced Parkinson’s disease, but the outcome depends on the quality of electrode placement. A patient is reported in whom the placement of the second electrode was not successful. Deformation field analysis of pre- and postoperative three dimensional magnetic resonance images showed an intraoperative brain movement of 2 mm in the region of the subthalamic nucleus (the target point). Electrode repositioning resulted in efficient stimulation effects. This case report shows the need to reduce risk factors for intraoperative brain movement and demonstrates the ability of deformation field analysis to quantify this complication.
Footnotes
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Competing interests: none declared
