Department of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Department of Neurosurgery, Karolinska University Hospital, Stockholm, Sweden; Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
School of Medicine, University of California San Diego, La Jolla, California, USA.
World Neurosurg. 2019 Jul;127:436-441. doi: 10.1016/j.wneu.2019.04.029. Epub 2019 Apr 9.
Clearpoint Smartframe is a magnetic resonance imaging-compatible stereotactic system often used to perform magnetic resonance imaging-guided biopsies. The system is typically mounted on the scalp through screws that pierce the skin and penetrate the outer table of the cranium. However, the frame can also be configured to be mounted directly onto the skull.
Here, we describe the clinical context well suited for a skull-mount Clearpoint Smartframe surgery. The patient suffered from a subcentimeter right parafourth ventricular contrast-enhancing lesion with hydrocephalus and underwent a right suboccipital needle biopsy followed by an occipital ventriculoperitoneal shunt. Although the hydrocephalus resolved with the ventriculoperitoneal shunt, the biopsy sample proved nondiagnostic. The patient underwent a second procedure during which the Clearpoint Smartframe was mounted onto the skull through space dissected free during the previous surgery. Diagnostic biopsy (H3K27 glioma) was performed followed by stereotactic laser ablation of the lesion.
We describe a case in which the skull mount Clearpoint Smartframe was used to biopsy and ablate a midline H3K27 glioma.
Clearpoint Smartframe 是一种磁共振成像兼容的立体定向系统，常用于进行磁共振成像引导下的活检。该系统通常通过穿透皮肤并穿透颅骨外板的螺钉安装在头皮上。然而，该框架也可以配置为直接安装在颅骨上。
在这里，我们描述了非常适合颅骨安装 Clearpoint Smartframe 手术的临床情况。患者患有右第四脑室亚厘米对比增强病变伴脑积水，并接受了右枕下入路针吸活检，随后进行了枕下入路脑室-腹腔分流术。尽管脑积水通过脑室-腹腔分流术得到解决，但活检样本未能明确诊断。患者接受了第二次手术，在第一次手术中分离出空间后，将 Clearpoint Smartframe 通过颅骨安装。随后进行了诊断性活检（H3K27 神经胶质瘤），并对病变进行了立体定向激光消融。
我们描述了一例使用颅骨安装的 Clearpoint Smartframe 进行活检和消融中线 H3K27 神经胶质瘤的病例。
