PMC4140146_01
Intraoperative images depicting (a) the Mi SPACE computer assisted navigation system and the radial access transsulcal corridor system, BrainPath (BP) (NICO corp., Indianapolis, Indiana), (b) BrainPath (BP), and (c) the small craniotomy site and dime-sized dural opening created along the predefined sulcus for an entry point. A narrow dural opening allows for a tight seal against the edges of the BP.
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fig1
A repeat CT head showed a hematomal expansion with mass effect and impending uncal herniation (see Figure 1 in Supplementary Materials available online at http://dx.doi.org/10.1155/2014/102307). SPACE approach was favoured. Starting with neuronavigation, Mi SPACE (Figures 1(a)-1(c)) was employed as outlined below.
Color coded fractional anisotropy (FA) maps obtained from the diffusion-tensor imaging (DTI) show collateral tissue preservation, with only small areas of decrease in FA in the left inferior longitudinal fasciculus (long arrow).
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fig2
CT imaging showed drainage of the hematoma, with improved mass effect (Figure 2 in Supplementary Materials). Fractional anisotropy (FA) maps revealed minimal areas of decrease in FA in the left inferior longitudinal fasciculus and left temporal subcortical white matter (Figure 2).