Frameless stereotactic guided neurosurgery: Clinical experience with an infrared based pointer device navigation system

Summary An infrared based frameless stereotactic navigation device (Easy Guide Neuro) was investigated for its clinical applicability, registration/application accuracy and limitations in a standard operating room set-up. In a five-month period 40 frameless stereotactic procedures (23 female, 17 male, mean age 46.4, yrs range 10–83) including 36 craniotomies and 4 spinal surgery procedures were performed. Image registration, data transfer and operation planning using skin fixed fiducials (between 5–10, mean 6.6) and CCT in 12 patients/MRI in 28 patients, generally was done the day before surgery. Clinical applicability was proven in all procedures with an additional time for pre-operative imaging and system application in the OR of 50 min mean (35–120 range). A useful registration was achieved in 39/40 patients (97.5%) with a registration accuracy of 3.4 mm (range 1.8–6.7) for brain surgery cases and 14.4 mm (6.8–25) for spine cases. This resulted in intra-operative application accuracy values for brain surgery of 4.2 mm mean (range 1–12). Enhanced registration/application accuracy values over the test period from 4.2/3.8 mm mean (Cases 1–20) up to 3.2/2 mm mean (Cases 21–40) was observed. In spinal surgery an application accuracy of 11.3 mm mean (range 5–20) was found. An intra-operative re-calibration because of system-head drift was necessary in none of the patients, nevertheless, application accuracy degradation due to brain shift was detected in every case. In conclusion, the system allowed a time sufficient accurate frameless intra-operative localisation guidance in cavernoma, meningioma, glioma, and brain metastasis surgery. In spinal surgery, the application accuracy exceeded clinical usefulness due to high registration inaccuracy using skin markers.     

新生儿缺氧缺血性脑病血清IGF-I、NPY和CGRP水平检测的临床意义

目的 探讨缺氧缺血性脑病患儿(HIE)血清IGF-I、NPY和CGRP水平的变化及临床意义.方法 应用放射免疫分析法对38例HIE新生儿急性期与35例HIE新生儿恢复期进行了血清IGF-I、NPY和CGRP水平检测,并与35例正常新生儿作比较.结果 HIE患儿急性期血清IGF-I、CGRP水平显著低于正常新生儿组(P...     

Five and Nine Year Check‐up of 314 Children with Neonatal Hyperbilirubinaemia

This is a part of a prospective follow‐up study of 1196 newborn infants with certain neonatal high risk factors. About one third of the group consisted of children with neonatal hyperbilirubinaemia; they had a serum bilirubin value > 340 mmol/l or had had blood exchange transfusions. They were born in 1971‐74 at the State Maternity Hospital, Helsinki. Thirteen children were severely handicapped and excluded from the series and 54 were not traced or parents refused to bring them to the check‐up. 314 children were examined at the age of five and/or nine years. The control series comprised 72 children. The results indicated that the children with neonatal hyperbilirubinaemia managed less well in neurological and psychological tests than the control group, they had poorer school marks and more often attended special classes for somatic and psychic handicaps or for the mentally retarded. Their results were, nevertheless, often better than those for the rest of the risk group.