The external wrapping of intracranial aneurysm is the definitive treatment of choice for surgical clipping or endovascular occlusion, yet there may exist considerable difficulties and risks because so far neither ideal wrapping techniques nor ideal wrapping materials have been obtained. An encapsulated aneurysm clip with biomembrane graft across the vessels is introduced in this article. By clipping the neck and wrapping the sack of aneurysm simultaneously, this clip successfully solves the problems of unreasonable encapsulated materials and techniques; it has been proved to be an effective method for treating intracranial refractory aneurysms.
Equipment Design ; Humans ; Intracranial Aneurysm ; surgery ; Ligation ; instrumentation ; Neurosurgical Procedures ; instrumentation ; Vascular Surgical Procedures ; instrumentation ; methods

Humans ; Minimally Invasive Surgical Procedures ; instrumentation ; methods ; Neurosurgical Procedures ; instrumentation ; methods

A surgical navigation system based on X-rays of C-arm with a calibration target has been studied and developed. Extracting images of markers in the two templates on the calibration target, the system is able to establish the relationship between different markers coordinates in different coordinate systems using the algorithm based on the layout of specific markers. The correction of X-ray image distortion and C-arm camera calibration are performed using the images of calibration target as bases. After the parameters of the C-arm projection model being determined, an X-ray image of surgical site will be acquired preoperatively; the surgical instruments will be tracked by the optical position system, and then virtual projections of instruments can be formed on preoperative images. Surgeons will perform operations with the guidance of the system. The C-arm can be used less frequently and the X-ray radiation can be reduced. Cadaveric spine specimen experiments and error analysis have underpinned the clinical feasibility of the system.
Algorithms ; Artifacts ; Calibration ; Fluoroscopy ; methods ; Humans ; Neurosurgical Procedures ; instrumentation ; methods ; Radiographic Image Enhancement ; methods ; Surgery, Computer-Assisted ; methods

Fiber photometry is a sensitive and easy way to detect changes in fluorescent signals. The combination of fiber photometry with various fluorescent biomarkers has substantially advanced neuroscience research over the last decade. Despite the wide use of fiber photometry in biomedical fields, the lack of a detailed and comprehensive protocol has limited progress and sometimes complicated the interpretation of data. Here, we describe detailed procedures of fiber photometry for the long-term monitoring of neuronal activity in freely-behaving animals, including surgery, apparatus setup, data collection, and analysis.
Animals ; Brain ; metabolism ; Calcium Signaling ; Female ; Male ; Mice ; Neurons ; metabolism ; Neurosurgical Procedures ; Optical Fibers ; Optical Imaging ; instrumentation ; methods ; Photometry ; instrumentation ; methods

OBJECTIVETo analyze the anesthetic management for neurosurgery using intraoperative magnetic resonance imaging (iMRI).

METHODSThirty patients with intracranial tumor received MRI for preoperative safety screening and the operation was performed with general anesthesia and support by MRI-compatible machines. The operative time, frequency and duration of MRI, MRI-related time (from the preparation for MRI to the beginning of the surgery), time delay by MRI, body temperature at the initial iMRI and special issues related to the scanning and perioperative anesthesia were recorded.

RESULTSThirty patients successfully completed the operations without any incidents related to anesthesia or scanning. The mean frequency of MRI was 1.8, the mean duration of MRI was 29.24 ∓ 10.10 min, and the MRI-related time was 43.83 ∓ 10.23 min; the time delay MRI was 92.63 ∓ 28.31 min, and the body temperature was significantly higher at 2 h after MRI than that after induction.

CONCLUSIONIn the anesthetic management for neurosurgery with iMRI, the anesthesiologists should focus on the safety precaution and anesthetic modulation according to the special environment and procedure of iMRI.

Adolescent ; Adult ; Anesthesia ; methods ; Brain Neoplasms ; surgery ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Monitoring, Intraoperative ; instrumentation ; methods ; Neuronavigation ; methods ; Neurosurgery ; Neurosurgical Procedures ; methods ; Young Adult

Brain Neoplasms ; surgery ; Computer Simulation ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Neurosurgical Procedures ; instrumentation ; methods ; Patient Care Planning ; Preoperative Care

OBJECTIVETo investigate the possibility of bridging small peripheral nerve gap using a de-acetyl chitosan conduit.

METHODSThe sciatic nerves of right sides were cut at SD rats. They were divided into 5 Groups randomly; Group A: epineurium suture in situ (n = 24); Group B: biological conduit with a small gap for bridging the peripheral nerve (n = 24, with 5 mm gap); Group C: epineurium suture with distal stump rotated 180 degrees (n = 24); Group D: bridging the nerve by biological conduits with a small gap, but the distal stump rotated 180 degrees (n = 24, with 5 mm gap); Group E: biological conduit with a small gap for bridging the peripheral nerve with NGF (n = 24). Electrophysiological examination, histological examination and myelinated axon counting were applied after 2, 4, 6, 8 weeks after operation respectively.

RESULTSRegenerated nerve fibers were seen in the distal nerve segments of all 5 groups; The nerve conduction velocity of small gap group (group B, D) was faster than that of corresponding simple epineurium suture group (group A, C) at all 2, 4, 6, 8 week time point (P < 0.05). The myelinated axon counting of small gap group (group B, D) was faster than that of corresponding simple epineurium suture group (group A, C) at all 4, 6, 8 week time point (P < 0.01), and there was no statistically significant difference at 2 week time point.

CONCLUSIONThe repair effects of chitin conduit bridging peripheral nerve with small gap (5 mm) are better than that of epineurium suture directly, and possess the potential to substitute the epineurium suture.

Animals ; Biocompatible Materials ; Chitosan ; Male ; Nerve Regeneration ; Neurosurgical Procedures ; instrumentation ; methods ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; injuries ; physiology ; surgery

Image guided surgical navigation system is the most advanced surgical apparatus, which develops most rapidly and has great application prospects in neurosurgery, orthopaedics, E.N.T. department etc. In current surgical navigation systems, windowing, segmenting and registration of medical images all depend on manual operation, and automation of image processing is urgently needed. This paper proposes the algorithm which realizes very well automatic windowing and segmentation of medical images: first, we analyze a lot of MRI and CT images and propose corresponding windowing algorithm according to their common features of intensity distribution. Experiments show that the effects of windowing of most MRI and CT images are optimized. Second, we propose the seed growing algorithm based on intensity connectivity,which can segment tumor and its boundary exactly by simply clicking the mouse, and control dynamically the results in real time. If computer memory permits, the algorithm can segment 3D images directly. Tests show that this function is able to shorten the time of surgical planning, lower the complexity, and improve the efficiency in navigation surgery.
Algorithms ; Brain Diseases ; diagnosis ; surgery ; Humans ; Image Enhancement ; methods ; Image Interpretation, Computer-Assisted ; instrumentation ; methods ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; instrumentation ; Magnetic Resonance Imaging ; Neurosurgical Procedures ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed

OBJECTIVE: To review endonasal endoscopic surgeries aided by Fusion image guided system, and to explore the application value of Fusion image guided system in endonasal endoscopic surgeries. METHOD: Retrospective research. Sixty cases of endonasal endoscopic surgeries aided by Fusion image guided system were analysed including chronic rhinosinusitis with polyp (n = 10), fungus sinusitis (n = 5), endoscopic optic nerve decompression (n = 16), inverted papilloma of the paranasal sinus (n = 9), ossifying fibroma of sphenoid bone (n = 1), malignance of the paranasal sinus (n = 9), cerebrospinal fluid leak (n = 5), hemangioma of orbital apex (n = 2) and orbital reconstruction (n = 3). RESULT: Sixty cases of endonasal endoscopic surgeries completed successfully without any complications. Fusion image guided system can help to identify the ostium of paranasal sinus, lamina papyracea and skull base. Fused CT-CTA images, or fused MR-MRA images can help to localize the optic nerve or internal carotid arteiy . Fused CT-MR images can help to detect the range of the tumor. It spent (7.13 ± 1.358) minutes for image guided system to do preoperative preparation and the surgical navigation accuracy reached less than 1mm after proficient. There was no device localization problem because of block or head set loosed. CONCLUSION Fusion image guided system make endonasal endoscopic surgery to be a true microinvasive and exact surgery. It spends less preoperative preparation time, has high surgical navigation accuracy, improves the surgical safety and reduces the surgical complications.
Cerebrospinal Fluid Leak ; surgery ; Endoscopy ; instrumentation ; Fibroma, Ossifying ; surgery ; Humans ; Nasal Surgical Procedures ; methods ; Neurosurgical Procedures ; Nose ; pathology ; Papilloma, Inverted ; surgery ; Paranasal Sinuses ; pathology ; Retrospective Studies ; Sinusitis ; surgery ; Sphenoid Bone ; pathology ; Surgery, Computer-Assisted ; methods

OBJECTIVE: To investigate the advantages of image guidance system in endoscopic optic nerve decompression of traumatic occlusion optic neuropathy affiliated with cerebrospinal rhinorrhea. METHOD: Retrospective review of 15 traumatic occlusion optic neuropathy affiliated with cerebrospinal rhinorrhea at our department between June 2006 and June 2010. Witch were performed endoscopic optic nerve decompression and cerebrospinal rhinorrhea euplastic by image guidance system. RESULT: After 3 months to 1 year follow-up, All the cases with cerebrospinal rhinorrhea euplastic were successful. Two cases recovered to 0.3-0.6 in visual activity. Two cases to 0.1-0.3. One case was less than 0.1. Two cases could see hand movement and 2 cases had light perception. Total effective rate was 60 percent (9/15). CONCLUSION Image guidance system combined with endoscopy provides accurate localization and identifies the operative borders and critical anatomical structure of skull base, optic nerve and internal carotid artery,and also clearly indicate their adjacent relations,also decreases surgical invasions and complications. Image guidance system can improve the accuracy and safety, particularly in local anatomic structure due to the trauma caused by changes in the relationship. It is a safety and effective therapy method.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; complications ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Neuroimaging ; instrumentation ; Neurosurgical Procedures ; instrumentation ; Optic Nerve Injuries ; complications ; surgery ; Retrospective Studies ; Surgery, Computer-Assisted ; Treatment Outcome ; Young Adult