Authors: R Bernays S Kollias Y Yonekawa
Publish Date: 2002/02/08
Volume: 44, Issue: 5, Pages: 438-442
Abstract
We demonstrate the usefulness of near realtime neuronavigation by open MRI systems for guidance of stereotactic evacuation of intracranial abscesses A 70yearold patient was referred to our institution with an intracranial left temporal abscess He presented with headache sensomotor aphasia and mild right hemiparesis The abscess 35×25 mm was stereotactically evacuated under MRI guidance and a recurrence of a daughter abscess was again evacuated on the 9th postoperative day Near realtime imaging showed an indentation of the abscess wall of 11 mm along the trajectory A thermosensitive MRI protocol demonstrated a higher temperature around the abscess capsule than in the brain tissue more distant to the capsule demonstrating the inflammatory process The patient had 6 weeks of antibiotic therapy for gramnegative bacteria and was discharged with improved clinical symptoms 5 weeks after admission Followup CT 2 months postoperatively showed a complete resolution of the abscess Open MRIguided interventions with near realtime imaging demonstrate the anatomical changes during an ongoing procedure and can be accommodated for enhancing the overall precision of stereotactic procedures Thermosensitive MRI protocols are capable of revealing temperature gradients around inflammatory processes
Keywords: