Stereotactic Brain Surgery

What Is Stereotactic Brain Surgery?

Stereotactic brain surgery is a minimally invasive neurosurgical procedure that is coordinate-based and does not surgically expose the target tissue. Today's stereotactic procedures use real-time imaging using computed tomography (CT) or magnetic resonance imaging (MRI), as well as computer-assisted instrument guidance. This means that images of the patient's anatomy and position are continuously taken during the procedure to ensure the correct localization of the treatment instruments.

The image-guided, computer-assisted calculation of the paths and distances of the instruments allows the experienced physician to move safely inside the skull. This is used, among other things, to puncture or remove deeply located brain tumors. In addition, vascular malformations can be targeted and treated. These interventions are summarized in oncological stereotaxis. On the other hand, functional stereotaxis involves treating movement disorders such as tremors and chronic pain.

For Which Diseases Can Stereotactic Surgery Be Considered?

Oncological stereotaxis describes procedures for the diagnosis and treatment of deeper tumors and vascular malformations in the brain. The minimally invasive and exact surgery spares healthy nerve tissue so that undesirable neurological deficits, as a result, can be largely avoided. Treatments include:

• Removal of vascular growths or malformations
• Surgical removal (resection) of tumors and metastases from the brain

Functional stereotaxis is a surgical procedure used to treat specific chronic pain and movement disorders by implanting stimulation systems in the brain or spinal cord or by intentionally damaging nerves:

• Treating chronic tremor
  • Parkinson's disease
  • Multiple sclerosis
  • Essential tremor
• Treating Tourette's syndrome
• Treating Parkinson's disease symptoms
• Treating of dystonia
• Relieving some forms of chronic pain

The Procedure of Stereotactic Surgery

During stereotactic brain surgery, the patient's head and surgical instruments are firmly fixed in a frame. Usually, under local anesthesia, fine instruments are inserted through small openings in the skull and safely placed by the physician at the exact pre-calculated points in the brain monitored by computer assistance and real-time imaging.

Risks, Side Effects, and Long-Term Consequences

Like all surgical procedures, stereotactic surgery carries risks. The process is carried out under local anesthesia, and the patient is under constant monitoring by a neurosurgeon and a neurologist. However, the risk of bleeding and occurrence of inflammation is relatively low (2-3%). The risk increases minimally if the surgery is carried out in both hemispheres of the brain. Surgery resulting in death or severe disability is extremely rare (<1 percent). For this reason, the risk/benefit ratio is acceptable, at least in severely affected patients.

Which Physicians and Clinics Are Specialised in Stereotactic Brain Surgery?

Specialists in stereotactic brain surgery are neurosurgeons. They work in neurosurgery clinics, which are usually part of university hospitals.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in stereotactic brain surgery and are awaiting your inquiry or treatment request.

Sources:

• Wannemacher et al. (Hrsg.): Strahlentherapie. 2. Auflage. Springer 2013, ISBN 3-540-88304-5.
• Piper: Innere Medizin. 2. Auflage. Springer 2012, ISBN 978-3-642-33107-7.
• Moskopp, Wassmann: Neurochirurgie. Schattauer 2014, ISBN 978-3-794-52442-6.
• Brandt et al.: Therapie und Verlauf neurologischer Erkrankungen. 6. Auflage. Kohlhammer 2012, ISBN 3-170-21674-0.