Precision resection of intra-axial CNS lesions by CT-based stereotactic craniotomy and computer monitored CO2 laser

Abstract

This report describes an open stereotactic technique by which a tumour volume reconstructed in stereotactic space from CT data is removed by stereotactic CO₂ laser vaporization. The position of the laser beam in relation to the tumour outlines is monitored by computer and displayed to the surgeon on a graphics display terminal in the operating room. Twenty-six (26) of these procedures have been performed on twenty-four (24) patients with deep-seated intraaxial neoplasms (23) and arteriovenous malformation (1). Post-operative CT scanning revealed no evidence of contrast enhancing lesions in nineteen (19) patients while a small amount of residual tumour was noted in five (5) patients post-operatively. This method has proven itself valuable for maintaining three-dimensional surgical orientation for the resection of intra-axial neoplasms from neurologically important areas.