Nonvolumetric stereotaxy-assisted craniotomy. Results in 50 consecutive cases.

Craniotomy using stereotactic techniques has the potential to improve the extent of tumor resection and to reduce wound and neurologic morbidity. Most reports of stereotaxy-assisted craniotomy (SC) for tumor resection have focused on techniques using sophisticated computer hardware and volumetric software. Results of nonvolumetric SC in 50 consecutive cases for tumor using the Brown-Roberts-Wells or Cosman-Roberts-Wells stereotactic systems are presented. Tumor type included malignant glial neoplasms (20 cases), metastases (19), benign glial tumors (5), meningiomas (4), and radiation necrosis (1). Results in the SC group were compared to a concurrent series of 50 conventional craniotomies (CC) for brain tumor by other surgeons. Sustained neurologic deficits were 4% in the SC group while 10% for CC. Wound complications were 4 and 8%, respectively. Median hospital stay was 5 days (mean 5.9, range 2-20) for SC and 7 days (mean 10.4, range 3-75) for CC. Low morbidity resections of many brain lesions can be performed using conventional stereotactic systems, the operating microscope and standard CT software.