Utility of Digital Camera-derived Intraoperative Images in the Planning of Epilepsy Surgery for Children

Utility of Digital Camera-derived Intraoperative Images in the Planning of Epilepsy Surgery for... AbstractOBJECTIVE:This study was undertaken to assess the utility of digital camera-derived intraoperative images in the planning of neurosurgery for children with epilepsyMETHODS:A hand-held digital camera was used to capture the exposed surgical field at the time of craniotomy for 11 children with medically intractable seizure disorders. Intraoperative somatosensory evoked potential recordings of phase reversals and direct cortical stimulation were used to map areas of eloquent brain tissue. Digital camera images were obtained to mark regions of functional brain tissue with respect to cortical surface landmarks and subdural grid placement. The digital camera images were then immediately downloaded, in the operating room, to a laptop computer, which was placed next to the electroencephalographic recording device. Using computer software, the epileptologist highlighted the primary and secondary zones of epileptogenesis, as well as the functional brain areas identified during the monitoring period, on the digital camera images on the computer screen. A neurosurgical map was thus created to aid the neurosurgeon and the epileptologist with the proposed cortical resections and multiple subpial transections.RESULTS:With the images obtained using the digital camera, the epilepsy team was able to observe the contacts of the grid electrodes with the brain during the procedure. Color printouts of the images served as references during the period of invasive monitoring. Zones of primary and secondary epileptogenesis, as well as areas of functional brain tissue, were identified and plotted on the digital camera images. Other benefits of the digital camera-derived images included the ability to accurately reposition the grids or letters marking eloquent brain tissue if they were inadvertently shifted during the procedure, the ease with which the images could be obtained and manipulated, the ability to assess postresection epileptiform activity of the surrounding brain tissue with images obtained while an electrocorticographic array was in place, the ability to provide the entire epilepsy team with updated information on the neurosurgical field while minimizing movement in the operating room, and facilitation, with neurosurgical maps, of discussions with the patients and their families concerning proposed cortical resectionsCONCLUSION:Digital camera images have become essential components for the planning of cortical resections for children with intractable epilepsy at our institution. We envision widespread application of this technology to other neurosurgical fields. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Utility of Digital Camera-derived Intraoperative Images in the Planning of Epilepsy Surgery for Children

Utility of Digital Camera-derived Intraoperative Images in the Planning of Epilepsy Surgery for Children

Utility of Digital Camera-derived Intraoperative Images in the Planning of Epilepsy Surgery for Children James T. Rutka, M.D., Ph.D., Hiroshi Otsubo, M.D., Shouhei Kitano, M.D., Hiroaki Sakamoto, M.D., Atsushi Shirasawa, M.D., Ayako Ochi, M.D., O. Carter Snead III, M .D. D iv is i o n s o f N e u r o s u r g e r y (JTR) a n d N e u r o l o g y ( H O , AS, A O , O C S ) , T h e H o s p ita l for S i c k C h i l d r e n , U n iv e r s ity o f T o r o n t o , T o r o n t o , O n t a r i o , C a n a d a , a n d t h e D e p a r t m e n t o f P e d ia t r ic N e u r o s u r g e r y (SK, HS), O s a k a G e n e r a l H o s p i t a l , O s a k a , J a p a n O B JE C T IV E : This study was undertaken to assess the utility of digital cam era-derived intraoperative images in the planning of neurosurgery for children w ith epilepsy. M E T H O D S : A hand-held digital cam era was used to capture the exposed surgical field at the tim e of craniotomy for 11 children w ith m edically intractable seizure disorders. Intraoperative som atosensory evoked potential record­ ings of phase reversals and direct cortical stim ulation w ere used to map areas of eloquent brain tissue. Digital cam era images w ere obtained to mark regions of functional brain tissue w ith respect to cortical surface landmarks and subdural grid placem ent. The digital cam era images w ere then im m ediately downloaded, in the operating room, to a laptop com puter, w hich was placed next to the electroencephalographic recording device. Using com puter software, the epileptologist highlighted the prim ary and secondary zones of epileptogenesis, as w ell as the functional brain areas identified during the m onitoring period, on the digital cam era images on the com puter screen. A neurosurgical map was thus created to aid the neurosurgeon and the epileptologist with the proposed cortical resections and m ultiple subpial transections. RESULTS: W ith the images obtained using the digital camera, the epilepsy...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199911000-00033
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:This study was undertaken to assess the utility of digital camera-derived intraoperative images in the planning of neurosurgery for children with epilepsyMETHODS:A hand-held digital camera was used to capture the exposed surgical field at the time of craniotomy for 11 children with medically intractable seizure disorders. Intraoperative somatosensory evoked potential recordings of phase reversals and direct cortical stimulation were used to map areas of eloquent brain tissue. Digital camera images were obtained to mark regions of functional brain tissue with respect to cortical surface landmarks and subdural grid placement. The digital camera images were then immediately downloaded, in the operating room, to a laptop computer, which was placed next to the electroencephalographic recording device. Using computer software, the epileptologist highlighted the primary and secondary zones of epileptogenesis, as well as the functional brain areas identified during the monitoring period, on the digital camera images on the computer screen. A neurosurgical map was thus created to aid the neurosurgeon and the epileptologist with the proposed cortical resections and multiple subpial transections.RESULTS:With the images obtained using the digital camera, the epilepsy team was able to observe the contacts of the grid electrodes with the brain during the procedure. Color printouts of the images served as references during the period of invasive monitoring. Zones of primary and secondary epileptogenesis, as well as areas of functional brain tissue, were identified and plotted on the digital camera images. Other benefits of the digital camera-derived images included the ability to accurately reposition the grids or letters marking eloquent brain tissue if they were inadvertently shifted during the procedure, the ease with which the images could be obtained and manipulated, the ability to assess postresection epileptiform activity of the surrounding brain tissue with images obtained while an electrocorticographic array was in place, the ability to provide the entire epilepsy team with updated information on the neurosurgical field while minimizing movement in the operating room, and facilitation, with neurosurgical maps, of discussions with the patients and their families concerning proposed cortical resectionsCONCLUSION:Digital camera images have become essential components for the planning of cortical resections for children with intractable epilepsy at our institution. We envision widespread application of this technology to other neurosurgical fields.

Journal

NeurosurgeryOxford University Press

Published: Nov 1, 1999

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