Cranial neuronavigation--a step forward or a step aside in modern neurosurgery

Neuronavigation is a result of the introduction and integration of high technologies into modern neurosurgery. The method is becoming increasingly available, and more than ever, its "fashionable", ungrounded application (literally, in each neurosurgical procedure) requires objective evaluation of its real usefulness. The aim of the present survey was to analyze the use of neuronavigation in the general fields of modern cranial neurosurgery. The reliability of the classical method of brain lesion localization was compared to neuronavigated localization. We studied the neuronavigation assisted interventions in tumor surgery, skull-base surgery, biopsies, neuroendoscopy, functional neurosurgery, vascular neurosurgery and surgical procedures in the proximity of functionally important cortical zones. We showed the modern tendencies in neuronavigation and outlined the social and economic aspects of neuronavigation-assisted neurosurgery. A summary of the advantages and disadvantages of frameless stereotaxy is made.