STEREOTAXY-GUIDED MICROSURGERY OF CEREBRA L-LESIONS

Stereotaxy-guided microsurgery offers significant advantages in the tr eatment of deep-seated cerebral lesions, or in lesions that cannot rel iably be localized because of their small size or lack of evident land marks. We report our experience with 16 stereotaxy-guided microsurgica l procedures performed with the Leksell or the Lerch stereotactic syst em. Small superficial lesions were operated on in 6 patients and deep- seated subcortical lesions in 10 patients. The lesion size ranged from 10 to 50 mm and the depth of the lesions varied between 5 and 65 mm. A transsulcal approach was chosen in patients with cavernomas and a tr anscortical or transtumoral one in patients presenting with cerebral t umors. In no patient was a new postoperative neurologic deficit found, i. e. 12 patients had neither a pre- nor a postoperative deficit. 2 p atients (with central lesions) of 4 presenting with preoperative defic its showed an impressive recovery, while in the other 2 patients with lesions in the dominant temporal lobe the neurologic deficit remained unchanged. Stereotaxy-guided microsurgery allows safe resection of sma ll or deep-seated cerebral lesions without postoperative morbidity in our series.