[Use of real time ultrasonography in neurosurgery. Peroperative value in adults]

The authors present their beginning experience in the use of a new technique applied to neurosurgery: that is real-time echography. A preliminary non operative experience has first been carried on. It concerned five adults who have been studied through surgical defects. Then, eight patients, were explored intra-operatively: concerning three cerebral abscesses, one intra-cerebral haematoma, two subcortical tumors and two biopsies. In these cases, the ultrasonographic study was performed through a 3 centimeters diameter craniotomy--in case of abscess or haematoma aspiration or of biopsy--or through a classic bone flap--in case of tumor extirpation. Echography allowed an easy study of intracerebral structures and lesions. Its permits to visualize subcortical neoplasms and thus to aim them with accuracy. In the treatment of brain abscess, real time echography gives the possibility of guiding and following the progression of the probe. It, also, allows to appreciate the reduction of the suppurated cavity and thus assures a more reliable efficacity. Such a procedure indeed facilitates brain tumor biopsy; but we think that such a technique should be used only if a classic stereotactic procedure is not considered as necessary and if the mass lesion is large enough (over 1.5 cm) and not too profondly seated.