Hong Kong Med J 1995;1:329-34 | Number 4, December 1995
How safe is computed tomography-guided stereotaxy in neurosurgery and how should we select patients?
TH Aung, MK Lee, JCK Kwok, SCL Leung
Neurosurgical Unit, Kwong Wah Hospital, Waterloo Road, Kowloon, Hong Kong
With the advent of the Brown-Roberts-Wells stereotactic frame to the Queen Elizabeth Hospital in 1987, an evaluation was made of criteria for the safety and selection of patients for CT-guided stereotaxy. Sixty-five stereotactic procedures were performed on 47 men and 18 women from October 1987 to December 1994, which included biopsy, drainage of abscesses, and craniotomies. Fifty-five patients were operated on under local anaesthesia and 10 received general anaesthesia. Pathology was established by frozen section at the time of operation in 64 cases (98.4%), with the exception of one lesion in the pons. Bleeding was the single cause of the 4.7% mortality encountered, all of which occured in the initial few procedures. A radio-opaque ventricular catheter threaded through the stereotactically-guided cannula was found to be useful for draining abscesses and irrigation. The careful planning and selection of patients is very important, especially when the lesions are located in the pons or hypothalamus.
Key words: Brown-Robert-Wells stereotactic frame; Surgical approach; Complications
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