{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["12"],"submitter":["Rennert RC"],"pubmed_abstract":["<h4>Background</h4>Approaches to subcortical lesions have traditionally been limited by the morbidity of white matter dissection and fixed blade retraction required to reach these targets. Visualization of deep surgical fields with a traditional operating microscope is also poor. Coordinated use of intra-operative image guidance, a tubular retractor (BrainPath<sup>®</sup>, Nico Corp, Indianapolis, Indiana), a high-definition exoscope (Vitom<sup>®</sup>, Karl Storz Endoscopy America, Inc, El Segundo, California), and a low-profile resection device (Myriad<sup>®</sup>, Nico Corp) facilitates atraumatic access to and resection of subcortical lesions including primary brain tumors, brain metastases, and intracerebral hemorrhages.[1] Use of pre-planned transsulcal and parafascicular trajectories based on magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) can further mitigate damage to white matter tracts with this technique.<h4>Case description</h4>We herein present details of the transsulcal parafascicular BrainPath<sup>®</sup>-assisted approach to subcortical lesions and demonstrate the utility of this technique using two patient examples: a spontaneous deep left posterior temporal lobe hematoma in a 41-year-old male and a left hippocampal glioblastoma in a 54-year-old female. Key steps include selection of appropriate patients with non-skull base subcortical lesions, preoperative trajectory and tube depth planning based on MRI (including diffusion-weighted imaging and DTI), patient positioning and operating room setup to facilitate pre-planned trajectories and surgeon ergonomics, and use of low-profile instruments with a two-handed surgical technique.<h4>Conclusion</h4>Given recent data demonstrating the utility of this approach for hematoma evacuation and a likely increased future usage of this technique,[2] surgeon familiarity with the above steps will be of increasing importance."],"journal":["Surgical neurology international"],"pagination":["107"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8053449"],"repository":["biostudies-literature"],"pubmed_title":["Transsulcal parafascicular brain path-assisted approach to subcortical lesions: 2-dimensional operative video."],"pmcid":["PMC8053449"],"pubmed_authors":["Rennert RC","Morris TW","Khani M","Day JD","Thomas K","Rodriguez A"],"additional_accession":[]},"is_claimable":false,"name":"Transsulcal parafascicular brain path-assisted approach to subcortical lesions: 2-dimensional operative video.","description":"<h4>Background</h4>Approaches to subcortical lesions have traditionally been limited by the morbidity of white matter dissection and fixed blade retraction required to reach these targets. Visualization of deep surgical fields with a traditional operating microscope is also poor. Coordinated use of intra-operative image guidance, a tubular retractor (BrainPath<sup>®</sup>, Nico Corp, Indianapolis, Indiana), a high-definition exoscope (Vitom<sup>®</sup>, Karl Storz Endoscopy America, Inc, El Segundo, California), and a low-profile resection device (Myriad<sup>®</sup>, Nico Corp) facilitates atraumatic access to and resection of subcortical lesions including primary brain tumors, brain metastases, and intracerebral hemorrhages.[1] Use of pre-planned transsulcal and parafascicular trajectories based on magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) can further mitigate damage to white matter tracts with this technique.<h4>Case description</h4>We herein present details of the transsulcal parafascicular BrainPath<sup>®</sup>-assisted approach to subcortical lesions and demonstrate the utility of this technique using two patient examples: a spontaneous deep left posterior temporal lobe hematoma in a 41-year-old male and a left hippocampal glioblastoma in a 54-year-old female. Key steps include selection of appropriate patients with non-skull base subcortical lesions, preoperative trajectory and tube depth planning based on MRI (including diffusion-weighted imaging and DTI), patient positioning and operating room setup to facilitate pre-planned trajectories and surgeon ergonomics, and use of low-profile instruments with a two-handed surgical technique.<h4>Conclusion</h4>Given recent data demonstrating the utility of this approach for hematoma evacuation and a likely increased future usage of this technique,[2] surgeon familiarity with the above steps will be of increasing importance.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021","modification":"2024-02-15T03:17:31.504Z","creation":"2022-02-09T15:51:32.722Z"},"accession":"S-EPMC8053449","cross_references":{"pubmed":["33880212"],"doi":["10.25259/SNI_776_2020"]}}