An adapter for computed tomography-guided stereotaxis

A new, versatile adapter for computed tomography-guided stereotaxis is presented. The instrument consists of a light aluminum frame, which by means of a nasion support and two ear plugs is fixed to the patient's head. Reproducibility of repeated fixations is very high. The adapter is fitted to most stereotactic frames and can be used in all adult patients. Comparison between computed tomography- and ventriculography-guided determinations of thalamic targets showed a mean difference of 0.6 and 0.7 mm for the x and y coordinates, respectively. The z coordinates seldom showed any measurable difference. We now perform all types of stereotactic neurosurgery (tumor biopsy, implantation of depth electrodes, thalamotomy, dentatotomy, cingulotomy, etc.) with computed tomography guidance only. The short-term results in a small number of patients have been at least as good as after conventional ventriculography-guided surgery. In addition to open stereotactic surgery, the adapter is also suitable for external stereotactic irradiation of intracranial targets with a linear accelerator.