FRAME-BASED STEROTACTIC LOCALIZATION OF BRAIN LESION FOR EXCISION

Introduction: Till the end of the 1980s, frame-based stereotaxy was the standard method for accurately localizing small brain lesions by introducing catheters into the lesion or for determining the tumor volume in space. The objective of this study was to analyze the caracteristics of frame-based stereotactic localization of brain lesion for excision and to compare the results of frame-based stereotactic localization of brain lesion for excision with results of craniotomy without using stereotaxy. Material and methods: This study analyzed the results of 100 surgically treated patients for brain lesion excision in the period of 2002-2006 at Department of neurosurgery University clinical center of Tuzla. There were 60 patients operated on by a craniotomy without using stereotaxy and 40 patients operated on by using frame-based stereotactic localization of brain lesion for excision. The Karnofsky Performance Score (KPS) was used to estimate the patient every day activity before and after surgery. Length of incision, size of craniotomy and duration of surgery were compared between two groups. Result: An average age in patients operated on by using frame-based stereotactic tumor localization (Group A) was 49.5 (SD +13 years) and in patients operated on by craniotomy without using stereotactic localization (Group B) 53 years (SD +12 years). The mean length of skin incision in Group A was 7 cm (SD +5.5) and in Group B 14.5 cm (SD +4.7). The mean size of craniotomy in frame-based stereotactic localization for brain lesion removal was 10.7 cm2 (SD +9.8), and in craniotomy without stereotaxy 18.5 cm2 (SD +7.7). Duration of surgery in patients of Group A was 68 minutes (SD +43), and in Group B 125 minutes in average (SD +47). In the Group A there was no significant change in Karnofsky, but in the Group B there was drop. Discussion and Conclusion: Frame-based stereotactic localization of brain lesion for excision gives advantages comparing craniotomy without using stereotaxy. Frame-based stereotaxy remains the gold standard for accurate targeting of smaller lesions.