Reformatted imaging to define the intercommissural line for CT-guided stereotaxic functional neurosurgery.

Abstract

Functional stereotaxic neurosurgery has traditionally required definition of the line between the anterior and posterior commissures as the basis for defining the target site for a procedure such as stereotaxic thalamotomy. While axial computed tomographic (CT) imaging precisely defines the third ventricle and the commissures, the planes of the axial images are not necessarily parallel to the important intercommissural line. A technique is described in which coronal oblique reformations are obtained, with the reformations passing through both the anterior and posterior commissures. Stereotaxic coordinates of the target obtained from this reformatted image are directly transferable to the CT-compatible Leksell frame. Both imaging and surgery are performed on the scanner, which is located in an operating room especially designed for CT-guided surgical procedures.