A small left posterior frontal meningioma.

The meningioma was excised in toto. Although it was planned to be done with image guidance but since this equipment was being used in other case author made a 5cm trephine craniotomy by giving a straight left paramedian incision( anterior to posterior) and surgery was done without any complications.





Coronal cuts of a young female demonstrating small tumour. Tumour was excised using BrainLab image guidance.

Below are images of a patient who had small meningioma, which was excised using image guided system.

A middle aged lady was operated by me today for a small meningioma using BrainLab Image Guided System. The surgery was done under local anaesthesia using Karam Chand trephine having adjustable dura guard. Total enblock excision was done along with the dura from where the tumour was arising. Pericranial graft was used to achieve complete dural closure. Whole procedure was completed in less than 30 minutes. See pictures below.


This is where I imagined where tumour will be.



Obviously I was wrong, tumour was more medial. This enabled me to do a 4cm trephine craniotomy right over the tumour.

BrainLab Image guided system showing exact location of meningioma. It was used only to surface mark the tumour.


Neatly trephined bone(4cm in diameter)

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Excised Meningioma

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Comment by Karam Chand Sharma on April 29, 2010 at 7:30am
The circles were drawn with ballpen. The medial circle is where I imagined the tumour would be and other circle is where image guided system told us the tumour is. The pointing device was for registeration without fiducials.
Comment by Kuok Cheong U on April 29, 2010 at 4:53am
good work! I also use imaging guiding technique doing a lot of invasvie procedure but not in the brain. I'm wondering how you can draw the circle on the scalp? by the way, I notice that another circle has been drawn on the scalp next to the initial one and the pointing instrutment is not pointing to neither of the circles, why?

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