OBJECTIVE: The release of results of International Subarachnoid Aneurysm Trial in 2003 caused a shift in the paradigm of management of ruptured intracranial aneurysms. The cases selected for microsurgical clipping nowadays are usually those patients with aneurysms that are not suitable for embolization, and are often complex and difficult. We devised an innovative application of operative planning and training for craniotomy and microsurgical clipping of intracranial aneurysms in a stereoscopic virtual reality environment. METHODS: Patient-specific Digital Imaging and Communications in Medicine data from computed tomographic angiography of the intracranial circulation and cranium were transferred to the workstation (Dextroscope; Volume Interactions Pte. Ltd., Singapore, Singapore). An aneurysm clip database was loaded into the patient data set. Three-dimensional volume rendering was followed by data coregistration and fusion. RESULTS: Virtual head positioning and craniotomy were carried out to simulate the microscopic visualization. Clip selection could be carried out with reference to the angle of application. This allows one to see the exposure and degree of obliteration of an aneurysm with the various angles of approach. CONCLUSION: The virtual craniotomy and microsurgical clipping application simulated the operative environment. Its role in neurosurgical training is encouraging and should be further developed.
OBJECTIVE: The release of results of International Subarachnoid Aneurysm Trial in 2003 caused a shift in the paradigm of management of ruptured intracranial aneurysms. The cases selected for microsurgical clipping nowadays are usually those patients with aneurysms that are not suitable for embolization, and are often complex and difficult. We devised an innovative application of operative planning and training for craniotomy and microsurgical clipping of intracranial aneurysms in a stereoscopic virtual reality environment. METHODS:Patient-specific Digital Imaging and Communications in Medicine data from computed tomographic angiography of the intracranial circulation and cranium were transferred to the workstation (Dextroscope; Volume Interactions Pte. Ltd., Singapore, Singapore). An aneurysmclip database was loaded into the patient data set. Three-dimensional volume rendering was followed by data coregistration and fusion. RESULTS: Virtual head positioning and craniotomy were carried out to simulate the microscopic visualization. Clip selection could be carried out with reference to the angle of application. This allows one to see the exposure and degree of obliteration of an aneurysm with the various angles of approach. CONCLUSION: The virtual craniotomy and microsurgical clipping application simulated the operative environment. Its role in neurosurgical training is encouraging and should be further developed.
Authors: Axel T Stadie; Ralf A Kockro; Luis Serra; Gerrit Fischer; Eike Schwandt; Peter Grunert; Robert Reisch Journal: Int J Comput Assist Radiol Surg Date: 2010-09-01 Impact factor: 2.924
Authors: Ali Alaraj; Cristian J Luciano; Daniel P Bailey; Abdussalam Elsenousi; Ben Z Roitberg; Antonio Bernardo; P Pat Banerjee; Fady T Charbel Journal: Neurosurgery Date: 2015-03 Impact factor: 4.654
Authors: Ali Alaraj; Michael G Lemole; Joshua H Finkle; Rachel Yudkowsky; Adam Wallace; Cristian Luciano; P Pat Banerjee; Silvio H Rizzi; Fady T Charbel Journal: Surg Neurol Int Date: 2011-04-28