Infrared thermography mapping plus neuronavigation target location in an eloquent area cavernoma resection

Abstract

Background: Safety and efficacy are irrebuttable goals in neurosurgery.

Methods: We performed a subcortical cavernoma resection in an eloquent area, where we recorded and compared the maximal and minimal brain temperature measured by an infrared thermographic camera and thermometer with the neuronavigation (NN) target location and real anatomical lesion location.

Results: The hottest cortical point correlated to the subcortical cavernoma location. The NN located the target at 10 mm away from the hottest point.

Conclusion: More studies are needed to better understand the thermic radiation of the brain in health and in disease, but we believe that evaluating brain temperature, it could be possible to improve accuracy in neurosurgery and generate more knowledge about brain metabolism in vivo.

Keywords: Brain shift; Brain temperature; Cavernoma; Eloquent area; Infrared thermography mapping; Neuronavigation.

Figure 1:

Panoramic thermographic photograph of the craniotomy, where the left frontal, parietal, and occipital lobes are exposed. The black arrow shows the hottest point of the exposed brain cortex, located in the supramarginal gyrus. The blue arrow shows the intraparietal sulcus.

Figure 2:

Neuronavigation location of the target.

Figure 3:

(a) Neuronavigation system localization of the target (blue circle); (b) Grid placement for the pointer thermographic recording where the yellow circle represents the hottest thermographic recording [coordinate B1 of Table 1] over the supramarginal gyrus; (c) A trans- sulcal access was performed in the point where the neuronavigation system located the lesion (dotted blue circle). The yellow circle represents the real subcortical localization of the cavernous angioma. The proximity of the hottest thermographic recording to the real localization of the lesion is evident.