Arteriovenous Malformations, Cavernoma, Intracerebral Hematoma, Tumor, Brain
Conditions
Keywords
brain shift, tumor, cavernoma, arteriovenous malformation, intracerebral hematoma
Brief summary
The purpose of the study is to calculate magnitude, type of intraoperative brain shift and assess possibility of it's prediction.
Detailed description
Brain shift is the main natural cause of major navigation imprecision. Despite numerous attempts no trials showed a possibility to calculate and predict it's value although some patterns were found. Some modern navigational features allow to partially resolve this problem. Manual shift correction allows to displace brain structures but can only be used if brain shift is linear. Intraoperative computed tomography (CT) and magnetic resonance imaging (MRI) allow to update navigational data but violate surgical workflow and cannot display brain tissue in real time. Intraoperative sonography has poorer quality, limited observe volume and lengthy learning curve. The purpose of the study is to calculate magnitude, type of intraoperative brain shift and assess possibility of it's prediction. For each patient a surgeon intraoperatively will assess location of brain surface, various intracranial structures and lesion margins during surgery. Postoperatively these data will be compared to lesion's characteristics, patient's state and intraoperative features.
Interventions
DEVICENavigation-guided surgery
Surgeon removes brain lesions and assesses brain shift with neuronavigation
Sponsors
Sklifosovsky Institute of Emergency Care
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* all intracranial tumors * cavernomas * arteriovenous malformations * spontaneous (non-traumatic) intracerebral hemorrhages * traumatic intracerebral hemorrhages * supratentorial localization * newly diagnosed * age 18-100 years * stable hemodynamics * error of patient registration in neuronavigation no more than 2 mm
Exclusion criteria
* rapid cerebral dislocation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Brain shift (in millimeters) | Intraoperatively | Maximal difference between disposition of different brain structures in preoperative scans and it's real intraoperative location |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Karnofsky Performance status in percents | within 10 days after surgery | Assesses patients' possibilities to self-service |
| Cerebral complications | From admission to intensive care unit after surgery till hospital discharge, up to 365 days | Which cerebral complications arose after surgery |
Countries
Russia
Contacts
Primary ContactAlexander Dmitriev, MD
Outcome results
None listed