Stereotactic neurosurgery involves mapping the brain in a three dimensional coordinate system with the help of MRI and CT scans and 3D computer workstations. Neurosurgeons can then accurately target any area of the brain using its 3D coordinates. Stereotactic neurosurgery broadly is classified into stereotactic biopsy and stereotactic brain surgery.
“Stereotactic biopsy” is a surgical procedure where a thin needle is inserted into the brain by a neurosurgeon to extract a small piece of tissue to examine under a microscope. The goal of this procedure is to diagnose an abnormality seen on an MRI or CT scan. While MRI and CT scans are very good at showing parts of the brain that are abnormal, they can’t yet tell us with 100% certainty what an abnormality represents – a cancerous tumor, a benign tumor, an infection, an inflammatory process, a vascular abnormality, or other pathology. Because the treatments for these abnormalities are so different, it is important to determine what a lesion is so that appropriate treatment can be recommended.
Stereotactic Biopsies are done either with a “frame” or “frameless”, depending on the surgeon’s preference and the location and size of the lesion.
For a frameless biopsy, you will be asked to get a special MRI or CT one or two days before the planned biopsy. This image is imported into a computer system that provides us with a 3-dimensional image of your brain and our biopsy target while we are in the operating room. We use this image, along with a biopsy guidance arm to guide our needle safely into the tumor target.
For a frame based biopsy, we attach a device known as a stereotactic frame to your head before obtaining the MRI or CT scan to be used with the image guidance system (picture). The frame is particularly useful for guiding the biopsy needle to small targets, or targets that are deeper in the brain. Both approaches have the same safety and success record. For both frame and frameless biopsies, a small incision is used and a small hole is drilled in the skull to allow the needle to pass through to the target. At the end of the operation the needle is removed and the incision is sutured or stapled closed. The operation can be done either with general anesthesia where you are asleep or with sedation where you are drowsy, but not fully unconscious.
“Stereotactic brain surgery” is a surgical procedure where lesion, frequently a brain tumor, is removed with assistance of image guidance, that is previously obtained images (usually an MRI) are used to guide the surgeon to the exact location of the lesion to facilitate as accurate a pathway through the brain and safe removal of as much abnormal tissue as possible while leaving normal, healthy brain relatively intact.
The greatest advantage of stereotactic procedures is the millimetric precision with which abnormalities located even deep inside the brain can be targeted using a thin needle. The operation can be done either with general anesthesia or with sedation. Patients are monitored for several hours following the procedure and usually go home within a day.
Siddarth Neuro Hospital is equipped with a state-of-the art CRW stereotactic system, which in combination with the 3.0 Tesla MRI and Multislice CT systems, ensures precision of the highest order during stereotactic procedures