Abstract #0058
Preventing visual field deficits from neurosurgery using intraoperative MRI
Gavin P Winston 1 , Pankaj Daga 2 , Mark J White 3,4 , Caroline Micallef 3,4 , Anna Miserocchi 5 , Laura Mancini 3,4 , Marc Modat 2 , Jason Stretton 1 , Meneka K Sidhu 1 , Mark R Symms 1 , David J Lythgoe 6 , John Thornton 3,4 , Tarek A Yousry 3,4 , Sebastien Ourselin 2 , John S Duncan 1 , and Andrew W McEvoy 5
1
Epilepsy Society MRI Unit, Department of
Clinical and Experimental Epilepsy, UCL Institute of
Neurology, London, England, United Kingdom,
2
UCL
Centre for Medical Image Computing, London, United
Kingdom,
3
Lysholm
Department of Neuroradiology, National Hospital for
Neurology and Neurosurgery, London, United Kingdom,
4
Neuroradiological
Academic Unit, Department of Brain Repair and
Rehabilitation, UCL Institute of Neurology, London,
United Kingdom,
5
Department
of Neurosurgery, National Hospital for Neurology and
Neurosurgery, London, United Kingdom,
6
Centre
for Neuroimaging Sciences, Institute of Psychiatry,
Kings College London, England, United Kingdom
Anterior temporal lobe resection (ATLR) for refractory
epilepsy may cause a visual field deficit (VFD) that
precludes driving. We studied 21 patients undergoing
ATLR in an intraoperative MRI (iMRI) suite. Preoperative
tractography of optic radiation was displayed on the
navigation and operating microscope displays either
without (9 patients) or with (12 patients) correction
for brain shift. Display of the optic radiation during
surgery significantly reduced the degree of VFD and no
patient developed a VFD that precluded driving (compared
to 13% of a historical non-iMRI cohort). Outcome did not
differ between iMRI guidance with and without brain
shift correction.
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