Icg and parasagittal lesions akil

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Icg and parasagittal lesions akil

  1. 1. “The use of Indocyanine Greenvideoangiography to optimize the dural opening for intracranial parasagittal lesions” Nussbaum et al Operative Neurosurgery March 2012
  2. 2. Reasons to choose the article• Parasagittal Meningioma coming soon• The issue was raised in previous meeting• the availability of the material
  3. 3. National Brain Aneurysm CentreSt joseph’s Hospital, St Paul, MN
  4. 4. • Technical note• A series of 3 cases• Optimization of dural opening in parasagittal lesions• Delineation of the cortical draining veins before dural opening
  5. 5. • To avoid cortical venous injury
  6. 6. Method• exposure of the dura• IV injection of 0.25mg/kg of IGC• Microscope with light source with a wave length ICG absorption• Visualization of the venous structure in real time• Marking of the visualized cortical veins• Strategic planning of the dura
  7. 7. Case 1• 73 year old female• confusion/leg weakness• large parasagittal mass• Method as previously described
  8. 8. • Video
  9. 9. Post Operative MRI
  10. 10. • First description of the use of ICG videoangiography to protect cortical draining veins• Injury to draining veins can be disastrous• Simple technique that can potentially prevent severe venous infarction
  11. 11. Conclusion• Safe• Fast• Inexpensive• Accurate• “can be utilised to assess the risk of sacrificing particular vein”

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