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Magnetic Resonance-Guided Stereotaxy for Infusions to the Pig Brain
Published on: March 31, 2023
Stereotactic Drainage of Brainstem Abscess With the BrainLab Varioguide™ System and the Airo™ Intraoperative CT
Cesar C Almeida1, Ayse Uzuner2, Ron L Alterman3
1Department of Neurology, Division of Neurosurgery, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
Background And Importance:
Stereotactic biopsies or needle aspirations of posterior fossa lesions are technically challenging. Here we report a novel technique for performing these procedures employing the Airo™ intraoperative computed tomographic (CT) scanner and the VarioGuide™ articulated arm (BrainLab, Munich, Germany).
Clinical Presentation:
A 62-yr-old woman presented with an irregularly shaped, enhancing lesion of the left pons/middle cerebellar peduncle. Slowed diffusion on magnetic resonance imaging suggested an abscess, but no definitive infectious agent/source could be identified. When the patient deteriorated despite broad-spectrum antibiotic therapy, she was taken to the operating room for stereotactic drainage of the abscess employing the described technique. A specific infectious agent (Eikenella corrodens) was identified from the aspirate, allowing for tailored antibiotic therapy. The procedure was well tolerated and the patient made a full recovery with minimal neurological sequelae.
Conclusion:
The combination of the Airo™ intraoperative CT and the Varioguide™ articulated arm allows for safe, accurate, and efficient targeting of posterior fossa lesions.
