Estereotaxia: Historia, generalidades y actualidades.

Article · January 2007with108 Reads
Source: DOAJ
El cerebro es considerado el órgano rector del ser humano, se caracteriza por su fragilidad, complejidad y delicadeza, por ende cualquier intervención quirúrgica sobre él debe ser precisa y certera. La presente publicación revisa de manera cronológica aspectos de relevancia nacional e internacional relacionados con la historia de la estereotaxia, aborda los principios médicos y técnicos en que se sustenta su funcionamiento, y resume las indicaciones, complicaciones y contraindicaciones de la técnica. Se explica la concepción de trabajo en equipo que requieren estos procederes, basado en la experiencia del Servicio de Neurocirugía de Cienfuegos, y se emiten consideraciones actuales del presente y futuro de la estereotaxia. Palabras Clave: CEREBRO; TECNICAS ESTEREOTAXICAS; HISTORIA DE LA MEDICINA Abstract The brain is considered the human being’s organ rector, it is characterized by its fragility, complexity and fineness, therefore any surgical intervention on him should be precise and sure. The present publication revises in way chronological aspects of national and international relevance related with the history of the stereotaxy, the medicals principles and technicians in that its operation is sustained approaches, and it summarizes the indications, complication and contraindications of the technique. The work conception is explained in team that they require these considerations, based on the experience of Service of Neurosurgery of Cienfuegos, current considerations of the present and future of the stereotaxy are emitted. Key words: Brain; stereotaxic technique; history of medicine
  • [Show abstract] [Hide abstract] ABSTRACT: The stereotactic localization directed by cerebral angiography, usually stereotactic angiography, consists in obtaining two non-parallel images of the vascular cerebral tree carrying out an angiography with the placement of a stereotactic frame and a set of fiducials markers. The Computarized System for Intraoperative Stereotactic Angiography Localization (ANGIOWIN), designed at the International Center for Neurological Restoration, is a medical software for the localization of vascular cerebral structures. It can be used as complement in computed-assisted image-guided microsurgical approaches, such as arteriovenous malformations (AVMs) resections, mycotic or haematoma associated aneurysms clipping, vascularized tumors resections, etc. Two angiographic images are obtained using the known DSA method during the intraoperative microsurgical approach. Afterward, they are transferred to a personal computer and the projections of fiducial markers are used to calculate a homogeneous transformation matrix that relates the 3D frame coordinate of a target to its projected position in the image planeo Then, the neurosurgeon can obtain the stereotactic coordinates of any angiographic target like AVM feeding arteries. In this way, the system contributes to improve the microsurgical approach, facilitating the spatial recognition of vascular structures. This fact, avoids more manipulation and damage to the surrounding cerebral tissue, which rebounds in a reduction of the complications risk and in a decrease of the surgical time. In this work the principal characteristics, possibilities and advantages of its use are introduced, as well as the work methodology.
    Article · Dec 1999
  • [Show abstract] [Hide abstract] ABSTRACT: Needle biopsy using a CT-guided stereotaxic technique was performed in 121 cases of suspected brain tumour. Using this technique, it is possible to perform biopsies safely and accurately on even small and deep-seated lesions with a minimum of surgical intervention. However, accurate diagnoses are sometimes not possible when only a small number of viable cells are obtained, such as in lesions containing old haematoma, cystic tumours, previously treated tumours or tumours which are either too hard or too soft. We were able to make accurate diagnoses in 98 of our 121 cases (81%). The accuracy of diagnosis is somewhat hampered by the small volume of sample material obtained using this biopsy technique, and this fact should be kept in mind when evaluating the histological material.
    Article · Feb 1988
  • [Show abstract] [Hide abstract] ABSTRACT: The evolution of more sophisticated imaging techniques has initiated a renewed interest in stereotactic devices, methods, and applications. The Brown-Roberts-Wells instrument was available to us early in its prototype stage, and this report reviews the first 500 cases using the system at the University of Southern California Medical Center Hospitals. Procedures were undertaken after recognition of apparent structural alterations on imaging studies, with objectives being both diagnostic and therapeutic. Target locations were predominantly within the cerebral centrum-basal ganglia (284 cases) and diencephalic-mesencephalic regions (129 cases). Operative objectives included: histological and microbiological assay, cyst and abscess aspiration, installation of temporary or permanent drainage conduits, point source and colloid base brachytherapy, cerebroscopy and ventriculoscopy with biopsy, aspiration, and excision, and intraoperative vascular localization. Using multiple instrumentation at the target point (741 point placements), we realized procedural objectives in 95.6% of the cases. The mortality was 0.2% and the morbidity was 1%: hematoma, 2 cases; infection, 1 case; increased deficit, 1 case; intraprocedural seizure, 1 case. A specific diagnosis was not obtained in 4.4% (necrosis, 10 cases; inflammatory response, 9 cases; granuloma, 1 case; gliosis, 1 case; diagnostic error, 1 case). Individual guidelines for case selection, technique, institutional requirements, and applications of the method are discussed.(ABSTRACT TRUNCATED AT 250 WORDS)
    Article · Jul 1987
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