Sulcal identification and neuronavigation in supratentorial cavernoma surgery

We present the rise of cortical sulci, segmented from magnetic resonance im aging, in image guided neurosurgery. Sulcal information was transferred to a surgical microscope with enhanced reality features. This assistance was u sed for the resection of supratentorial cavernomas (7 parients). Sulci were semi-automatically segmented from 30 MRI data sets. Sulci close to the cavernoma were selected and transfer red to the neuronavigation syst em which allows the superimposition of graphics into the right ocular of th e microscope. Selected sulci were displayed on the workstation and superimp osed into the ocular of the microscope. Cortical sulci proved to be useful for the recognition of the anatomical en vironment. The superimposed sulci helped to optimize location and size of t he skin incision as well as to guide the access to the cavernoma by using t he course of a sulcus as indirect trajectory.