A posteriori validation of pre-operative planning in functional neurosurgery by quantification of brain pneumocephalus

Abstract

Functional neurosurgery for Parkinson’s disease is based on the stereotactic introduction of electrodes in a small, deeply located, nucleus of the brain. This nucleus is targeted on pre-operative stereotactic MR acquisitions. The procedure is time-consuming and can lead to the development of a pneumocephalus (presence of air in the intracanial cavity) because of CSF leak. This pneumocephalus leads to a brain shift which can yield a significative deformation of the entire brain and thus cause potential errors in the pre-operatively determined position of the stereotactic targets. In this paper, we conduct an a posteriori validation of the pre-operative planning, by quantifying brain pneumocephalus from the registration of pre and immediate post-operative MR acquisitions.