Cavernous malformations--navigational supported surgery.

OBJECTIVE: Navigational supported surgery of intracranial lesions is expected to be associated with a lower rate of brain traumatization as well as an avoidance of additional neurological deficits and surgical morbidity. In our study we used the computer-assisted image guidance for resection of cerebral cavernous malformations.

METHODS: In all patients the planning procedure for the following image-guided surgery was realized using preoperative MRl data sets and a neuronavigation system (STP 4.0, SNN). In cases in which the cavernoma was situated near functional eloquent regions, functional MR images were fused preoperatively.

RESULTS: During the last 24 months, 21 patients were surgically treated for cerebral cavernoma. No patient was operated twice. The mean size of cavernoma was 18.3 mm, ranging from 5 to 60 mm, the mean distance between cortical surface and cavernoma was 26 mm, ranging from 5 to 50 mm. The surgical procedure lasted in the median 180 min. All patients showed an identical or better neurological outcome.

CONCLUSIONS: Neuronavigation allows an accurate definition of the intraoperative target, a correct approach and a safe surgery. With the help of neuronavigation the surgical approach and the extirpation of cavernous malformations were realized in a comfortable and safe way and allowed a minimization of tissue manipulation.