Abstract:
INTRODUCTION:Intraoperative detection of residual tumor remains an important challenge in surgery to treat gliomas. New developments in optical techniques offer non-invasive high-resolution imaging that may integrate well into the workflow of neurosurgical operations. Using an intracranial glioma model, we have recently shown that time domain optical coherence tomography (OCT) allows discrimination of normal brain, diffusely invaded brain tissue, and solid tumor. OCT imaging allowed acquisition of 2D and 3D data arrays for multiplanar analysis of the tumor to brain interface. In this study we have analyzed biopsy specimens of human brain tumors and we present the first feasibility study of intraoperative OCT and post-image acquisition processing for non-invasive imaging of the brain and brain tumor. METHODS:We used a Sirius 713 Tomograph with a superluminescence diode emitting light at a near infrared central wavelength of 1,310 nm and a coherence length of 15 microm. The light is passed through an optical mono mode fiber to a modified OCT adapter containing a lens system with a working distance of 10 cm and an integrated pilot laser. Navigation-registered tumor biopsies were imaged ex vivo and the intraoperative site of optical tissue analysis was registered by marker acquisition using a neuronavigation system. RESULTS:Optical coherence tomography non-contact measurements of brain and brain tumor tissue produced B-scan images of 4 mm in width and 1.5-2.0 mm in depth at an axial and lateral optical resolution of 15 microm. OCT imaging demonstrated a different microstructure and characteristic signal attenuation profiles of tumor versus normal brain. Post-image acquisition processing and automated detection of the tissue to air interface was used to realign A-scans to compensate for image distortions caused by pulse- and respiration-induced movements of the target volume. Realigned images allowed monitoring of intensity changes within the scan line and facilitated selection of areas for the averaging of A-scans and the calculation of attenuation coefficients for specific regions of interest. CONCLUSION:This feasibility study has demonstrated that OCT analysis of the tissue microstructure and light attenuation characteristics discriminate normal brain, areas of tumor infiltrated brain, solid tumor, and necrosis. The working distance of the OCT adapter and the A-scan acquisition rate conceptually allows integration of the OCT applicator into the optical path of the operating microscopes. This would allow a continuous analysis of the resection plain, providing optical tomography, thereby adding a third dimension to the microscopic view and information on the light attenuation characteristics of the tissue.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Böhringer HJ,Lankenau E,Stellmacher F,Reusche E,Hüttmann G,Giese Adoi
10.1007/s00701-009-0248-ysubject
Has Abstractpub_date
2009-05-01 00:00:00pages
507-17; discussion 517issue
5eissn
0001-6268issn
0942-0940journal_volume
151pub_type
杂志文章abstract:BACKGROUND:Cerebral vasospasm following subarachnoid haemorrhage (SAH) remains one of the major factors contributing to poor overall patient outcome. Prostaglandin F2-alpha (PGF2a) induces vasoconstriction. After SAH, PGF2a leads to cerebral inflammation and enhanced vasoconstriction, resulting in cerebral vasospasm. L...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3419-2
更新日期:2018-02-01 00:00:00
abstract::Diffuse brain injury in rabbits was caused by injecting olive oil and saline into one internal carotid artery. In this report, the fourth of a series, the effects of this experimental brain injury on respiration and acid-base balance of blood are analyzed. The animals that withstood the injury best were those that had...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405898
更新日期:1975-01-01 00:00:00
abstract::Selection of the approach and technique for surgical repair of aneurysm of the vertebrobasilar artery system is mainly based on angiographic features. This report emphasizes that planning the surgical procedure should also include preoperative evaluation of the individual skull base configuration, as well as the relat...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01428505
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Advantages of telemetric devices for long-term intracranial pressure (ICP) measurement have been mentioned several times in the literature. However, descriptions of associated complications are lacking. Therefore, the presented observational study focused on clinical and radiological findings after insertion...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-013-1991-7
更新日期:2014-05-01 00:00:00
abstract::Basal forebrain cells of foetal rats were transplanted into the subarachnoid space of adult rats harbouring a kainic acid-induced unilateral lesion in the nucleus basalis magnocellularis. Passive avoidance response tests were performed eight weeks after the transplantation, and the results were compared with those of ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01404951
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:Separation of the posterior ring apophysis of an adjacent vertebral body can sometimes accompany lumbar intervertebral disc herniation. The condition can be both difficult to detect in conventional radiographs and is somewhat controversial to treat. Although there is general agreement on the frequent need fo...
journal_title:Acta neurochirurgica
pub_type: 临床试验,杂志文章
doi:10.1007/s00701-003-0044-z
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:We developed a new simple therapeutic method for the treatment of chronic subdural hematoma (CSDH) without irrigation and drainage. This method is characterized by replacement of the hematoma with oxygen. METHODS:Seventy patients (seventy-eight sides) with CSDH were treated with this method from May 1994 to...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-005-0689-x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:As the anatomical three-dimensional (3D) positional relationship around the anterior clinoid process (ACP) is complex, experience of many surgeries is necessary to understand anterior clinoidectomy (AC). We prepared a 3D synthetic image from computed tomographic angiography (CTA) and magnetic resonance imagi...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-017-3202-4
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Early repair of myelomeningocoele (MM) is associated with decreased morbidity and mortality. In sub-Saharan Africa, the peculiar harsh economic and social realities make late presentation, malnutrition and sepsis at presentation prevalent. As these factors may affect surgical repair, the aim of this study was...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-0002-x
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:To investigate characteristic clinical and radiological features of extradural arachnoid cysts (EDACs) in the thoracolumbar region, a retrospective review of medical records and imaging studies was performed. EDACs are well known but relatively rare lesions in the thoracolumbar spinal canal. The most common ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-1110-6
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Cranial nerves (CNs) crossing between the brainstem and skull base at the level of the tentorial hiatus may be at risk in temporomesial surgery involving subpial dissection and/or tumorous growth leading to distorted anatomy. We aimed to identify the surgical steps most likely to result in CN damage in this t...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-011-0987-4
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Successful deep brain stimulation is mostly dependent on accurate positioning of the leads at the optimal target points. We investigated whether the identification of the subthalamic nucleus in T2-weighted 3-T MRI, fluid-attenuated inversion recovery 3-T MRI and susceptibility-weighted 3-T MRI is confirmed b...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-014-2328-x
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Post-operative haematoma and visual deterioration are rare but serious complications after trans-sphenoidal surgery. For more reliable decompression of the optic nerve, we introduce a new technique for volume reduction of the cavity remaining after trans-sphenoidal resection of macroadenomas. TECHNIQUE:Afte...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-008-1583-0
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Chronic subdural haematomas (cSDHs) have shown an increasing incidence in an ageing population over the last 20 years, while unacceptable recurrence rates of up to 30 % persist. The recurrence rate of cSDH seems to be related to the excessive neoangiogenesis in the parietal membrane, which is mediated via va...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00701-016-2949-3
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Patient-reported experience measures (PREMs) are a unique measure of experience of patients which can help address the quality of care of the patients. OBJECTIVE:Our aim of the study is to collect quality of care outcomes with our newly navigated transcranial magnetic stimulation patient-reported experience...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-020-04268-y
更新日期:2020-07-01 00:00:00
abstract::A method is described for monitoring the relationship between CSF pulse pressure and ICP in clinical patients. Highly significant linear relationships were found during 65 continuous ICP recordings in 58 patients. The slope value of this relationship showed a positive correlation with the elastance coefficient, a volu...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403461
更新日期:1986-01-01 00:00:00
abstract::In fifteen cases of brain stem lesions caused by basal tumours, operations, injuries, arteriosclerosis or multiple sclerosis, a paradoxical activity of jaw closing muscles during jaw opening was observed. This inverse activity was the cause of severe trismus in 8 cases. It is the manifestation of a faulty programming ...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01403831
更新日期:1985-01-01 00:00:00
abstract:AIM:To study the value of early (24 h) post-operative ACTH and serum cortisol as predictors of remission after transsphenoidal surgery in Cushing's disease. METHODS:We prospectively studied 44 patients who underwent transsphenoidal surgery for Cushing's disease between 1997 and 2005. The mean follow-up period of patie...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-007-1133-1
更新日期:2007-01-01 00:00:00
abstract::While bone invasion and hyperostosis are frequent phenomena in meningiomas, primary intra-osseous meningiomas are rare. With only 15 reported cases, the osteolytic form of primary intra-osseous meningiomas is most uncommon. Its occurrence in the skull base is an extra-ordinary exception. We have reviewed and categoriz...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-004-0380-7
更新日期:2004-11-01 00:00:00
abstract::The purpose of this study was to evaluate whether wide surgical exposures result in poorer outcome of lumbar disc surgery compared to smaller traditional exposures. The aim was also to assess if a dural tear has any impact on the postoperative clinical outcome. One hundred and twenty-two patients (56 women and 66 men,...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01411260
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Lumbar microendoscopic discectomy (MED) is a minimally invasive transmuscular approach that combines standard lumbar microsurgical techniques with endoscopy. MED advantages include reduced tissue trauma, direct visualization of the nerve root and disc disease, and allowing bony decompression in cases with sp...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2743-2
更新日期:2016-04-01 00:00:00
abstract::Homovanillic acid (HVA) and 5-hydroxyindolacetic acid (5-HIAA) in ventricular CSF were determined in 19 patients (12 female 7 male) with brain tumours. No relationship was found between ventricular fluid pressure (VFP) and levels of HVA and 5-HIAA. A relationship was observed between ventricular CSF, HVA concentration...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01405944
更新日期:1976-01-01 00:00:00
abstract:BACKGROUND:Infratentorial supracerebellar approach via microscope still has some limitations in resection of pineal region tumors. METHODS:The authors describe a purely endoscopic infratentorial supracerebellar approach for resection of pineal region tumors with matched air-driven arm and navigation. The lateral obliq...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-016-2895-0
更新日期:2016-11-01 00:00:00
abstract::Although disorders of cerebral autoregulation are commonly seen in neurosurgical disease, there is currently no test of autoregulation in widespread use that may be performed safely at the bedside. The presence of autoregulation, however, can be seen in the brief hyperemic response in the middle cerebral artery distri...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01407660
更新日期:1991-01-01 00:00:00
abstract::The present study compares the clinical outcome, as expressed by the Glasgow outcome scale, of two groups of severely head injured patients treated before (49 patients) and after (72 patients) the establishment of a neurosurgical intensive care (NIC) unit at the department of neurosurgery. Uppsala University Hospital....
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01402049
更新日期:1991-01-01 00:00:00
abstract::Specimens of the anterior pituitary lobe were investigated histologically in 28 craniopharyngioma patients operated on trans-sphenoidally. The pituitary glands in 3 patients revealed lymphocytic invasion giving a histological appearance typical of lymphocytic hypophysitis (incidence: 11%). At follow-up examination all...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/BF01476492
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:By now it has been well established that vertebral artery injury (VAI) is associated with unstable cervical spine injuries resulting from blunt trauma. A more complete understanding of predisposing factors and the mechanism of injury in VAI should result in improved outcomes and reduced risk for patients wit...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-012-1499-6
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Microscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforde...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00701-017-3438-z
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Pituitary transposition preserving gland function is possible when approaching superior clival region tumors. Clinical experience along with detailed anatomical knowledge makes this technique safe and effective. METHOD:We present a step by step description of our technique based on the most recent anatomica...
journal_title:Acta neurochirurgica
pub_type: 杂志文章
doi:10.1007/s00701-019-04012-1
更新日期:2019-10-01 00:00:00
abstract::Cavernous hemangiomas are most commonly found within the subcortical neural parenchyma near the fissura Rolandi, in the basal ganglia, or in the brain stem. Because of advancing neuro-imaging technology and thus resulting in a higher incidence of cavernous hemangiomas they have rising impact in neurosurgery. We presen...
journal_title:Acta neurochirurgica
pub_type: 杂志文章,评审
doi:10.1007/s00701-005-0567-6
更新日期:2005-10-01 00:00:00