Descripción general
Resonancia magnética intraoperatoria
Resonancia magnética intraoperatoria
Debido a que el cerebro puede desplazarse durante la cirugía, las técnicas de cartografía cerebral y las imágenes por resonancia magnética intraoperatoria crean imágenes precisas del cerebro que guían al neurocirujano para extirpar de manera eficaz solo el tumor y evitar cualquier otro tejido cerebral a fin de preservar las funciones motrices, del lenguaje y otras funciones cerebrales importantes.
En la cirugía de cerebro asistida por computadora, los cirujanos utilizan tecnologías de imágenes, como resonancias magnéticas, resonancias magnéticas intraoperatorias, tomografías computarizadas y tomografías por emisión de positrones para crear un modelo tridimensional de tu cerebro. Esto puede hacerse antes o, en algunos casos, durante la cirugía.
Este modelo le permite al cirujano del cerebro (neurocirujano) planificar la manera más segura de tratar tu afección. Durante la cirugía, el sistema por computadora guía con precisión al cirujano hacia las áreas del cerebro que requieren tratamiento.
Por qué se realiza
Estimulación cerebral profunda
Estimulación cerebral profunda
La estimulación cerebral profunda consiste en implantar un electrodo dentro del cerebro. La cantidad de estimulación generada por el electrodo se controla mediante un dispositivo similar a un marcapasos colocado bajo la piel del pecho. Un cable que se encuentra bajo la piel conecta el dispositivo con el electrodo.
La cirugía de cerebro asistida por computadora se utiliza para tratar una variedad de afecciones que afectan al cerebro, como tumores cerebrales, enfermedad de Parkinson, temblor hereditario, epilepsia y malformaciones arteriovenosas.
Si tienes un tumor cerebral, el cirujano puede combinar la cirugía asistida por computadora con la cirugía de cerebro con el paciente despierto.
Los neurocirujanos de Mayo Clinic también utilizan técnicas asistidas por computadora para tratar tumores cerebrales, malformaciones arteriovenosas, neuralgia del trigémino y otras afecciones con haces de radiación dirigidos en forma precisa mediante la radiocirugía estereotáctica del cerebro.
Si tienes epilepsia, enfermedad de Parkinson o temblor hereditario, la cirugía asistida por computadora puede incluir una estimulación cerebral profunda. Los cirujanos pueden usar imágenes por resonancia magnética para mapear el cerebro y trazar la ubicación de los electrodos.
Riesgos
Computer-assisted brain surgery helps to lower the risks of surgeries. By creating a 3D model of your brain, your neurosurgeon can plan the safest way to treat your condition. Computer assistance also helps guide your surgeon to the precise areas of the brain that need treatment. However, every surgery carries some risk.
Stereotactic radiosurgery has few risks, and potential side effects are often temporary. They may include feeling very tired, and soreness and swelling at the treatment site. Side effects also may include scalp irritation. Rarely, brain changes may occur months after the surgery.
Deep brain stimulation also has risks, including infection, bleeding, seizures and stroke.
If part of the skull is removed for surgery, potential risks include bleeding, swelling or infection.
Cómo prepararte
Follow the instructions from your healthcare team about what to do in the days and hours before brain surgery. You may need to stop certain medicines before surgery.
For example, blood-thinning medicines slow the blood-clotting process. These medicines can increase the risk of bleeding. Talk to your healthcare team about whether you need to stop taking a blood-thinning medicine before surgery and for how long.
Qué esperar
What happens during computer-assisted brain surgery depends on the type of surgery you're having. A medicine that puts you in a sleep-like state, known as general anesthesia, often is used in computer-assisted brain surgery. If you're having awake brain surgery, you're given medicines to feel relaxed and block pain but that keep you awake. This allows you to interact with the surgery team to maximize safety during surgery.
Sometimes a piece of skull is removed to operate on the brain. In other surgeries, such as stereotactic radiosurgery, no cuts are made. Instead, radiation is aimed at the area of the brain needing treatment.
Your neurosurgeon may take imaging scans during surgery, known as intraoperative MRI or CT using a portable CT scanner. The imaging machine used to take the images may be in the operating room and brought to you for the imaging. Or it may be in a room next door and you're brought to the machine for the images.
Resultados
Computer-assisted brain surgery helps surgeons more precisely plan and conduct brain surgeries. When brain surgery is more precise, it leads to better outcomes and fewer complications.
Using imaging during surgery, known as intraoperative MRI or CT, helps neurosurgeons take into account changes to the brain that occur during surgery. For example, the brain can shift during surgery. Taking images during surgery helps to make the surgery more precise. Intraoperative imaging also alerts surgeons to complications so that they can be addressed quickly.
Some research has found that using intraoperative MRIs helps surgeons more completely remove a tumor or damaged tissue. Computer-assisted brain surgery also allows more healthy tissue to be spared while targeting only the brain tissue that's being operated on.