Intra-operative ultrasound.

Abstract

Real time intraoperative ultrasound can provide instant evaluation of the operative field. One can expect high quality images of intracranial anatomy. With such information, the neurosurgeon can make determinations of direction and position as well as depth of the lesion. The procedure is safe and easy to perform. There are no radiation hazards present. It may be advantageous to keep the ultrasound available as one operates to visualize the progress of tumor removal; it can also be utilized after closure of the dura for bleeding or other complications. Biopsy procedures and localization of lesions in the brain can be extremely problematic. The neurosurgeon does not have the luxury of exploring a brain during a craniotomy as a general surgeon does in exploring an abdomen during laparotomy. Despite the fact that modern day technology with angiography and CT scanning may provide excellent preoperative localization information, the neurosurgeon must translate the information into his own perspective when operating and lesions may be missed by a millimeter. Once the transducer visualizes the brain substance, the neurosurgeon can actually observe the progress of the craniotomy.