Multimodal 3D computer planning system for the implantation of stereotactic electrodes in refractory epilepsy

Neurosurgery is evolving towards the use of minimally invasive procedures. In this dissertation, we present several tools designed to fulfill the multimodal and multidisciplinary requirements of Stereoencephalography (SEEG) and epilepsy surgery. The resulting planning platform, named SYLVIUS, provid...

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Detalles Bibliográficos
Autor: Higueras-Esteban, Alfredo
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:CBUC, CESCA
Repositorio:TDR. Tesis Doctorales en Red
OAI Identifier:oai:www.tdx.cat:10803/672880
Acceso en línea:http://hdl.handle.net/10803/672880
Access Level:acceso abierto
Palabra clave:Epilepsy surgery
Stereoelectroencephalography (SEEG)
Diffusion-weighted imaging (DWI)
Angiography
Surgical workflow
Multimodal
Multidisciplinary
Stereotactic neurosurgery
Cirugía de epilepsia
Estereoelectroencefalografía (SEEG)
Imagen ponderada por difusión (DWI)
Angiografía
Flujo de trabajo quirúrgico
Multidisciplinar
Neurocirugía estereotáctica
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Descripción
Sumario:Neurosurgery is evolving towards the use of minimally invasive procedures. In this dissertation, we present several tools designed to fulfill the multimodal and multidisciplinary requirements of Stereoencephalography (SEEG) and epilepsy surgery. The resulting planning platform, named SYLVIUS, provides a digitalized workflow intended to facilitate clinical decision-making which has been used in Hospital del Mar, Barcelona for the evaluation of nineteen SEEG implantations. The platform allows for 3D-stereo visualization and interaction with head-tracking capabilities, providing novel interaction tools for the analysis of vascular and tractography data. Also, we present a clinical study of the risks and benefits of using digital subtraction angiography (DSA) performed with SYLVIUS. Finally, we describe two interactive trajectory planning tools, one designed to early signal the presence of vascular structures near a trajectory, and another one to find avascular alternative paths to a given potentially dangerous one maximizing adherence to either the entry, the target, or the insertion angle of the initial trajectory.