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The first 25 slides, exactly as they appear. The full deck has 62 content slides.
Neurosurgery
Stereotactic Resection of Malignant Brain Tumors
Built from Feldman — Neurosurgical Operative Atlas: Neuro-Oncology
What’s inside
9 sections · 62 slides
Overview
- First, why does this operation matter?
- What does 'stereotactic' actually mean?
- A roadmap: four processes for every case
Choosing the right patient
Matching the operation to the disease, the tumor, and the person
- Selection is the single most important step
- Two lenses for every decision
- The three goals of surgery
- Biopsy or resection: often the same sitting
- Primary brain tumors: when to resect
- Metastatic brain tumors: a wider calculation
Preparing before the operation
Medical work-up, the right scans, and planning the safest path
- Medical work-up before surgery
- Managing seizures, swelling, and pressure
- Choosing the imaging: MRI vs CT
- How the planning scan is acquired
- The core idea: safest path, not shortest
Anesthesia: awake or asleep?
Teamwork, monitoring, and controlling brain pressure
- Anesthetic considerations up front
- What can be mapped asleep versus awake
- Comfort and cooperation for awake cases
- Hyperventilation and diuresis: a trade-off
Setting the stage in the OR
Room layout, positioning, registration, and the virtual rehearsal
- Why the setup is half the battle
- Configuring the operating room
- Optimum operating room configuration
- Positioning the patient
- Registration: locking the map to the patient
- Surgical planning: a virtual rehearsal
Opening the skull
Incision, craniotomy, dura, and the double-check with ultrasound
- Skin incision and scalp flap
- Localized lesions with retractors placed
- Craniotomy and internal fiducials
- A real-time double-check, then open the dura
- Cruciate dural incision and stereotactic probe
Mapping the brain to save
Finding motor, sensory, and language cortex first
- Why map at all?
- Mapping the motor strip with SSEPs
- Functional mapping of the motor strip
- Awake stimulation mapping
- Mapping language, and handling seizures
- Ultrasound as a resection guide
- Intraoperative ultrasound of a metastasis
Removing the tumor
The transsulcal route, tailoring technique to pathology, and inspecting the bed
- The transsulcal approach
- Technique varies with the pathology
- Protecting vessels and eloquent cortex
- Inspecting the resection bed
- Inspecting the resection bed
- Closing up
After surgery, and three real cases
Recovery, complication prevention, and the technique in action
- Postoperative management
- Case 1: multiple brain metastases
- Pre- and postoperative MRI, multiple metastases
- Case 2: glioma in Wernicke's area
- Glioma in Wernicke's area, pre- and postoperative
- Case 3: glioma deep in the motor cortex
- Glioma deep in the motor cortex, pre- and postoperative
- Numbers worth remembering
- Why does stereotactic technique let the surgeon prefer the SAFEST approach rather than the shortest one?
- Take-home messages
- Neurosurgical Operative Atlas: Neuro-Oncology