Department of Neurology, Division of Neurosurgery, University of São Paulo Medical School (FMUSP), São Paulo, Brazil.
Marmara University School of Medicine, Istanbul, Turkey.
Oper Neurosurg (Hagerstown). 2018 Apr 1;14(4):E46-E50. doi: 10.1093/ons/opx126.
Stereotactic biopsies or needle aspirations of posterior fossa lesions are technically challenging. Here we report a novel technique for performing these procedures employing the Airo™ intraoperative computed tomographic (CT) scanner and the VarioGuide™ articulated arm (BrainLab, Munich, Germany).
A 62-yr-old woman presented with an irregularly shaped, enhancing lesion of the left pons/middle cerebellar peduncle. Slowed diffusion on magnetic resonance imaging suggested an abscess, but no definitive infectious agent/source could be identified. When the patient deteriorated despite broad-spectrum antibiotic therapy, she was taken to the operating room for stereotactic drainage of the abscess employing the described technique. A specific infectious agent (Eikenella corrodens) was identified from the aspirate, allowing for tailored antibiotic therapy. The procedure was well tolerated and the patient made a full recovery with minimal neurological sequelae.
The combination of the Airo™ intraoperative CT and the Varioguide™ articulated arm allows for safe, accurate, and efficient targeting of posterior fossa lesions.
立体定向活检或后颅窝病变的经皮穿刺抽吸术具有一定的技术挑战性。在此，我们报告了一种使用 Airo™术中计算机断层扫描（CT）扫描仪和 VarioGuide™ articulated arm（BrainLab，慕尼黑，德国）进行这些手术的新技术。
一位 62 岁的女性因左脑桥/小脑中脑脚不规则强化病变就诊。磁共振弥散成像显示弥散受限，提示脓肿，但未能明确感染源。尽管给予广谱抗生素治疗，患者病情仍恶化，遂采用描述的技术进行立体定向脓肿引流。从吸出物中鉴定出特定的感染源（腐败埃肯菌），并进行了针对性的抗生素治疗。该操作安全耐受，患者完全康复，仅有轻微的神经后遗症。
Airo™术中 CT 和 Varioguide™ articulated arm 的结合可实现后颅窝病变的安全、准确和高效靶向定位。
