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Simulation to Locate Burr Hole Sites in a Patient for Deep Brain Stimulation Surgery and Clipping of Intracranial Aneurysm
Article first published online: 1 JUN 2012
© 2012 International Neuromodulation Society
Neuromodulation: Technology at the Neural Interface
Volume 16, Issue 1, pages 51–54, January/February 2013
How to Cite
Kobayashi, K., Nakamura, S., Watanabe, M., Shimoda, K., Morishita, T., Sumi, K., Otaka, T., Obuchi, T., Shijyo, K., Kano, T., Oshima, H., Fukaya, C., Yamamoto, T. and Katayama, Y. (2013), Simulation to Locate Burr Hole Sites in a Patient for Deep Brain Stimulation Surgery and Clipping of Intracranial Aneurysm. Neuromodulation: Technology at the Neural Interface, 16: 51–54. doi: 10.1111/j.1525-1403.2012.00466.x
Conflict of Interest: The authors reported no conflict of interest.
- Issue published online: 1 FEB 2013
- Article first published online: 1 JUN 2012
- Received: November 14, 2011 Revised: January 16, 2012 Accepted: April 18, 2012
- Deep brain stimulation;
- frontal craniotomy;
- Parkinson's disease;
- unruptured aneurysm
Background and Objective: Deep brain stimulation (DBS) candidates with neurologic diseases such as unruptured aneurysm present additional challenges to neurosurgeons when craniotomy must precede DBS surgery. Such craniotomy may potentially overlap with intended burr hole sites for the later insertion of DBS electrodes, and the skin incision for craniotomy may lie very close to or intersect with that for the burr holes. We report here a case of forehead craniotomy prior to DBS surgery in which we employed a neuronavigation system to simulate locations for the craniotomy and burr holes.
Method: A 62-year-old male patient with Parkinson's disease was a candidate for DBS. He also had an aneurysm and was planned first to undergo frontal craniotomy for clipping before the DBS surgery. The locations of the craniotomy, burr holes, and skin incisions were therefore simulated using a neuronavigation system during craniotomy.
Results: Two weeks after the craniotomy, the patient underwent DBS surgery. Planning software confirmed the absence of cortical veins beneath the entry points of tentative burr holes and aided trajectory planning. The DBS surgery was performed without the interference of the burr holes and head pins and the craniotomy.
Conclusion: Simulation of the locations of craniotomy and burr holes using a neuronavigation system proved valuable in the present case of frontal craniotomy before DBS surgery.