Apuzzo M L, Sabshin J K
Neurosurgery. 1983 Mar;12(3):277-85. doi: 10.1227/00006123-198303000-00005.
A prototype Brown-Roberts-Welles stereotactic instrument has been used as both a diagnostic and a therapeutic surgical adjunct in cases of intracranial mass lesions. Eighty-three procedures (142 point placements) required computerized guidance stereotaxy. The unit accomplished point intracranial access with an accuracy of greater than 1 mm. Pathological processes included a variety of neoplasms (56 cases), strokes (7 cases), and infections (20 cases) affecting deep regions of the cerebral hemispheres, the ventricular system, the cerebellum, and the rostral brain stem. Procedures were undertaken with the patient under local anesthesia for biopsy (300 point specimens), culture, evacuation, aspiration, endoscopic excision, and implantation of radioisotopes. The techniques and instrumentation for each of these procedures are described. Procedural objectives were satisfactorily accomplished with no mortality and an overall complication rate of 4%. Recovery of tissue specific to establish a histological diagnosis or the etiological factors related to each disease process was realized in 94% of the cases. These results were obtained with scanner utilization times averaging 15 minutes and procedurally related patient recovery periods of less than 4 hours. The value and adaptability of the instrumentation and techniques are illustrated, and potential future applications are discussed.
一台布朗 - 罗伯茨 - 韦尔斯立体定向仪器原型已被用作颅内占位性病变病例的诊断和治疗手术辅助工具。八十三例手术（142个靶点放置）需要计算机辅助立体定向。该设备实现了颅内靶点穿刺，精度大于1毫米。病理过程包括影响大脑半球深部区域、脑室系统、小脑和延髓脑干的各种肿瘤（56例）、中风（7例）和感染（20例）。手术在局部麻醉下对患者进行，用于活检（300个组织标本）、培养、引流、抽吸、内镜切除和放射性同位素植入。描述了这些手术中的每一种的技术和仪器。手术目标令人满意地完成，无死亡病例，总体并发症发生率为4%。94%的病例实现了获取用于建立组织学诊断的组织或与每个疾病过程相关的病因因素。这些结果是在平均扫描时间为15分钟且与手术相关的患者恢复期少于4小时的情况下获得的。说明了仪器和技术的价值及适应性，并讨论了未来潜在的应用。
