Skip to main content
SpringerLink
Log in

Rapid determination of thalamic CT-stereotactic coordinates: A method

  • Technical Notes
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The anterior and posterior commissures (AC; PC) are the most frequently used reference points for target determination in functional stereotactic surgery. Computerized tomography (CT) has been slow in replacing ventriculography for identification of these points, primarily because in most methods described to date, the AC/PC plane had to be identified by reformatted CT images or cumbersome mapping procedures. The authors describe their methodology for determination of functional CT-stereotactic coordinates using the Brown-Robert-Wells (BRW) stereotactic system, axial CT imaging, and a proportional method to rapidly scale standard stereotactic map coordinates to the diencephalic size of any individual patient.

  1. 1.

    CT gantry angulation coinciding with Twining's line allows rapid identification of the AC/PC plane on axial CT.

  2. 2.

    Determination of the AC/PC distance with the “measure distance” function of the scanner enables the surgeon to rapidly find the proportional coordinates for either V.O.P., V.im., or V.C.

  3. 3.

    This localization method takes little more time than a routine stereotactic biopsy. Its application is easy, demanding only a few minutes of CT-console time, employing the standard computer software available in every current CT scanner.

The method was been successfully employed in 25 functional thalamic procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Birg W, Mundinger F (1982) Direct target point determination for stereotactic brain operations from CT data and the calculation of setting parameters for polar-coordinate stereotactic devices. Appl Neurophysiol 45: 387–395

    PubMed  Google Scholar 

  2. Brierley JB, Beck E (1959) The significance in human stereotactic brain surgery of individual variation in the diencephalon and globus pallidus. J Neurol Neurosurg Psychiatry 22: 287–298

    PubMed  Google Scholar 

  3. Bullard DE, Nashold BS (1988) Posttraumatic movement disorders. In: Lunsford LD (ed) Modern stereotactic neurosurgery. M Nijhoff Pub, Boston, pp 341–352

    Google Scholar 

  4. Gildenberg PL (1988) General concepts of stereotactic surgery. In: Lunsford LD (ed) Modern stereotactic neurosurgery. M Nijhoff Pub, Boston, pp 3–11

    Google Scholar 

  5. Hardy TL, Bertrand G, Thompson CJ (1979) Position of the medial internal capsular border in relation to third ventricular width. Appl Neurophysiol 42: 234–247

    PubMed  Google Scholar 

  6. Hariz MI, Bergenheim T (1990) A comparative study on ventriculographic and computerized tomography-guided determinations of brain targets in functional Stereotaxis. J Neurosurg 73: 565–571

    PubMed  Google Scholar 

  7. Hawrylyshyn Pa, Tasker RR, Organ LW (1976/77) Third ventricular width and the thalamocapsular border. Appl Neurophysiol 39: 34–42

    Google Scholar 

  8. Jeanmonod D, Thomas DGT (1989) Application of CT-directed stereotaxy in the determination of functional neurosurgical targets in the diencephalon and cerebral hemisphere. Br J Neurosurg 3: 337–342

    PubMed  Google Scholar 

  9. Kelly PJ (1988) Contemporary stereotactic ventralis lateral thalamotomy in the treatment of Parkinsonian tremor and other movement disorders. In: Heilbrun MP (ed) Stereotactic neurosurgery. Concepts in neurosurgery, vol 2. Williams & Wilkins, Baltimore, pp 133–147

    Google Scholar 

  10. Kelly PJ, Derome P, Guiot G (1978) Thalamic spatial variability and the surgical results of lesions placed with neurophysiologic control. Surg Neurol 9: 307–315

    PubMed  Google Scholar 

  11. Laitinen L (1966) Thalamic targets in the stereotaxic treatment of Parkinson's disease. J Neurosurg 24: 82–85

    PubMed  Google Scholar 

  12. Laitinen LV (1985) Brain targets in surgery for Parkinson's disease. Results of a survey of neurosurgeons. J Neurosurg 62: 349–351

    PubMed  Google Scholar 

  13. Latchaw RE, Lunsford LD, Kennedy WH (1985) Reformatted imaging to define the intercommissural line for CT-guided stereotaxic functional neurosurgery. AJNR 6: 429–433

    PubMed  Google Scholar 

  14. Maeda T (1989) Lateral coordinates of nucleus ventralis intermedius target for tremor alleviation. Stereotact Funct Neurosurg 52: 191–199

    PubMed  Google Scholar 

  15. Molina Negro P (1979) Functional surgery of abnormal movements. In: Rasmussen T, Marino R (eds) Functional neurosurgery. Raven Press, New York, pp 89–121

    Google Scholar 

  16. Mundinger F, Birg W (1988) The imaging-compatible RiechertMundinger System. In: Lunsford LD (ed) Modern stereotactic neurosurgery. M Nijhoff Pub, Boston, pp 13–25

    Google Scholar 

  17. Ohye C (1988) Selective thalamotomy for movement disorders: microrecording stimulation techniques and results. In: Lunsford LD (ed) Modern stereotactic neurosurgery. M Nijhoff Pub, Boston, pp 315–331

    Google Scholar 

  18. Schaltenbrand G, Wahren W (1977) Atlas for stereotaxy of the human brain. Year Book, London. G Thieme, Stuttgart

    Google Scholar 

  19. Siegfried J, Rea GL (1988) Thalamotomy for Parkinson's disease. In: Lunsford LD (ed) Modern stereotactic neurosurgery. M Nijhoff Pub, Boston, pp 333–340

    Google Scholar 

  20. Tasker RR, Organ LW, Hawrylyshyn PA (1982) The thalamus and midbrain of man. C Thomas Pub, Springfield, Ill

    Google Scholar 

  21. Tasker RR, Yamashiro K, Lenz F, Dostrovsky JO (1988) Thalamotomy for Parkinson's disease: microelectrode technique. In: Lunsford LD (ed) Modern stereotactic neurosurgery. M Nijhoff Pub, Boston, pp 297–314

    Google Scholar 

Download references

Author information

Author notes

  1. R. Spiegelmann

    Present address: Department of Neurosurgery, The Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel

Authors and Affiliations

  1. Department of Neurosurgery, University of Florida, Gainesville, Florida, USA

    R. Spiegelmann & W. A. Friedman

Authors
  1. R. Spiegelmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. A. Friedman
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Spiegelmann, R., Friedman, W.A. Rapid determination of thalamic CT-stereotactic coordinates: A method. Acta neurochir 110, 77–81 (1991). https://doi.org/10.1007/BF01402051

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01402051

Keywords

Search

Navigation