Three-dimensional brain surface visualization for epilepsy surgery of focal cortical dysplasia |
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| Institution: | 1. Department of Neurosurgery, Massachusetts General Hospital, 55 Fruit Street, White 502, Boston, MA 02114, USA;2. Harvard Medical School, Boston, MA, USA;3. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA;1. Department of Neurological Surgery, Northwestern University McGaw Medical Center, 676 N. St. Clair Street, Suite 2210, Chicago, IL 60611, USA;2. Department of Pathology, Northwestern University McGaw Medical Center, Chicago, IL, USA;3. Department of Radiation Oncology, Northwestern University McGaw Medical Center, Chicago, IL, USA;1. Division of Neurovascular Surgery and Endovascular Neurosurgery, Department of Neurosurgery, Thomas Jefferson University Hospital, 909 Walnut Street, Philadelphia, PA 19107, USA;2. Rancocas Valley Anesthesia, Cinnaminson, NJ, USA;1. Cerebrovascular Center, Cleveland Clinic, Cleveland, OH, USA;2. Departments of Neurosurgery and Radiology, University of Texas Southwestern, Dallas, TX, USA;1. Department of Anatomic Pathology, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA;2. Department of Neurosurgery, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA;1. Clinical Neurocardiology Section, CNP/DIR/NINDS/NIH, Bethesda, MD 20892-1620, USA;2. University of Miami Miller School of Medicine, Miami, FL 33136, USA;3. Chaim Sheba Medical Center, Tel Ha-Shomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel |
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| Abstract: | Focal cortical dysplasia (FCD) causes medically intractable seizures in 5–10% of adult epilepsy patients, but patients can become seizure free through surgical resection. The authors present the utility of three-dimensional surface visualization (3DSV) that expands on existing imaging datasets to highlight surface vasculature as a tool for achieving more successful resections in patients with FCD. In this prospective series of six patients, preoperative 3DSV was performed for planning the surgical approach to the lesion and for intraoperative guidance. Reconstructions involved volume rendering of a contrast-enhanced dataset to visualize surface venous vasculature. Postoperatively, five of the six patients had complete resections, with one patient having a subtotal resection due to proximity to crucial vasculature. We report that 3DSV is a useful tool for surgical planning, since topographical relationships between lesion location and surface vasculature landmarks are less likely to change with surgical progress. |
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| Keywords: | Brain imaging Epilepsy Focal cortical dysplasia 3D imaging |
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