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T Struffert

Publications and source records attributed to T Struffert.

14 recordsLinked to original sources
PubMed2002

Virtual endoscopy combined with intraoperative neuronavigation for planning of endoscopic surgery in patients with occlusive hydrocephalus and intracranial cysts.

We assessed the clinical value of MR ventriculoscopy (virtual endoscopy, VE) combined with image-guided frameless stereotaxy for endoscopic surgery of occlusive hydrocephalus and intracranial cysts. VE was obtained in 20 patients with hydrocephalus and three with intracranial cysts. All surgical operations were endoscopic. The path of the rigid endoscope to the target point was planned using neuronavigation. VE was carried out along the same trajectory retrospectively in 20 cases and prospectively in three. The results were analysed for demonstration of anatomical landmarks and structures at risk. VE was successful in all patients. Possible obstacles to endoscopic access to the lamina terminalis and the basal cisterns and structures at risk, such as the basilar artery, were clearly shown in relation to the direction of the endoscope. However, the floor of the third ventricle and septum pellucidum were not clearly seen and possible abnormalities could therefore not be appreciated. VE can provide realistic simulation of endoscopic third ventriculostomy and cystostomy. The appropriate trepanation point and trajectory of the endoscope can be assessed with regard to the size of the foramen of Monro and the position of vulnerable structures. This simulated trajectory can be adapted to the field of operation by image-guided neuronavigation. This regime may potentially reduce the risk of damage to intracranial structures.

Adolescent↗
PubMed2002

[Evaluation of MR angiography in the presentation of intracranial aneurysms].

In recent years the diagnostic potential of magnetic resonance angiographic acquisition techniques has been improved. Today aneurysms are investigated by MR angiography with a high diagnostic potential. In the pretreatment assessment important details can be depicted by MRA with high efficacy. This review article gives an evaluation on the most important techniques, CE-MRA and 3D-TOF-MRA.

Contrast Media↗
PubMed2002

[Screening for aneurysms in risk groups: meaningful?].

There is a controversy discussion on screening for aneurysms in risk groups. True guidelines do not exist so far. It seems that screening for familial aneurysms is not advisable today. But adult dominant polycystic kidney disease (ADPKD) patients with a familial history of SAH should be screened because of a high prevalence rate of 25% for intracranial aneurysms in this population. Screening should be performed every 2 to 3 years by MRI angiography in this special risk group.

Genetic Predisposition to Disease↗
PubMed2002

Error analysis in cranial neuronavigation.

Neuronavigation systems are now an important component of many modern neurosurgical treatment strategies. Their support facilities intraoperative orientation and makes neurosurgical operations more precise and less traumatic. Computer-aided neurosurgery is definitively not a temporary fashionable phenomenon, the concept of neuronavigation is here to stay. This report summarizes a ten-years-long experience and presents an error analysis of 108 failures (12.4 %) in a total of 874 image-guided cranial neurosurgical procedures with an arm-linked (mechanical) system and two different infrared-light emitting (optical) systems. The application of neuronavigation incurs multiple reasons for pitfalls because of the complex man-machine interface. Principally, we have to differentiate two types of errors: "machine made errors" due to soft- or hardware failure and "man made errors" generally, due to inadequate handling of the navigation system. The error analysis demonstrated that the so-called human interface plays the main role causing a high error rate.

Bias↗
PubMed2001

Virtual MRI endoscopy: detection of anomalies of the ventricular anatomy and its possible role as a presurgical planning tool for endoscopic third ventriculostomy.

BACKGROUND: Many anatomical anomalies have the potential to impair the efficacy of endoscopic third ventriculostomy (ETV) and increase the surgical morbidity. By virtual magnetic resonance imaging (MRI) endoscopy, the real endoscopic view into the ventricular system can be simulated. It was the objective of the present study to investigate if this simulation is sensitive enough to detect anatomical anomalies of the ventricular system. METHOD: In 18 hydrocephalic patients, first neuronavigationally guided ETV, then virtual MRI endoscopy were performed. This study design allowed for selection of a path for virtual MRI endoscopy, which was identical to that used during surgery, making the real and the virtual view on anatomical structures of the ventricular system highly comparable. It was investigated whether the intra-operatively identified anatomical anomalies could likewise be depicted on virtual MR endoscopic images. FINDINGS: Seven anatomical variants (not enlarged interventricular foramen n=2, atrophic corpus callosum and split fornical bodies n=1, narrow retroclival space n=1, prominent basilar tip n=1, opaque and thick/atypically declining third ventricular floor n=2) were encountered in 5 of the 18 patients during surgery. The five variants of the non-membraneous structures were identified by virtual MRI endoscopy (sensitivity 71%), whereas the anatomical variants of the third ventricular floor were missed. Both the normal as well as the variant third ventricular floor could not be visualised and appeared as a defect. Through this artefact, the anatomy of the major vessels in the interpeduncular cistern could be assessed. INTERPRETATION: The sensitivity of virtual MRI endoscopy for detection of anatomical variants of the ventricular system is low. Its potential usefulness as a presurgical planning tool inspite of this low sensitivity rate is discussed.

Adolescent↗
PubMed2001

[Lumbar arachnoiditis as differential chronic spinal symptoms diagnosis].

Lumbar epiduro-arachnoiditis is an infectious disease of the three mengial layers. It is often caused by surgical interventions on the spine. In this survey etiologic factors, clinical symptoms and radiological findings are compared. The radiologic classification of Delamater is described by three clinical cases. The diagnostic value of different procedures such as myelography, postmyelographic computed tomography and MR imaging is evaluated.

Arachnoid↗
PubMed2000

[Herpes simplex virus encephalitis: neuroradiologic differential diagnosis].

Herpes simplex virus encephalitis (HSE) is the most frequent viral encephalitis, as a rule with the starting point and centre within the temporal lobe. If untreated, HSE is usually fatal, thus diagnosis has to be established rapidly. Treatment with Acyclovir should begin as soon as possible. As MRI is extremely sensitive in detecting the early inflammatory changes, it should be initially performed, especially as in the early stadium CT may be unspecific. We recommend the following examination protocol: coronar T1-weighted MR imaging before and after administration of gadopentetate dimeglumine, coronar FLAIR sequence and axial T2-weighted imaging. The diagnostic proof is to show the evidence of viral DNA by polymerase chain reaction (PCR) in cerebrospinal liquor.

Acyclovir↗