[Stereotactically-guided microsurgery in cerebral processes].

Stereotaxy-guided microsurgery offers significant advantages in the treatment of deep-seated cerebral lesions, or in lesions that cannot reliably be localized because of their small size or lack of evident landmarks. We report our experience with 16 stereotaxy-guided microsurgical procedures performed with the Leksell or the Lerch stereotactic system. Small superficial lesions were operated on in 6 patients and deep-seated subcortical lesions in 10 patients. The lesion size ranged from 10 to 50 mm and the depth of the lesions varied between 5 and 65 mm. A trans-sulcus approach was chosen in patients with cavernomas and a transcortical or transtumoral one in patients presenting with cerebral tumors. In no patient was a new postoperative neurologic deficit found, i.e. 12 patients had neither a pre- nor a postoperative deficit. 2 patients (with central lesions) of 4 presenting with preoperative deficits showed an impressive recovery, while in the other 2 patients with lesions in the dominant temporal lobe the neurologic deficit remained unchanged. Stereotaxy-guided microsurgery allows safe resection of small or deep-seated cerebral lesions without postoperative morbidity in our series.