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Original Contribution TRANS-SULCAL MICROSURGICAL APPROACH TO INTRA-CEREBRAL METASTASES

Objective: The sophistication of medical technologies facilitates the diagnosis of various lesions in the deep parts of the brain hemispheres. That occurs the need of improved surgical techniques that these lesions can be achieved with minimal damage to the cortex. Our goal was to introduce into clinical practice trans-sulcal microsurgical approach to intracerebral lesions. 287 patients with intracerebral lesions were operated for the period of 1995-2012. Of these 142 cases of glial tumors and 61 metastases located supratentorialy, 21 cases of cerebellar tumors and 63 cases of hypertensive intracerebral hematoma. Methods: To minimize iatrogenic damage of the cerebral cortex, the trans-sulcal microsurgical approach was used in all of these cases. Results: The approach was successfully applied in all 287 cases. In 271 of them there was a regress in neurological deficit and improvement of the overall condition in the early postoperative period. In 16 of cases there was a lethal end due to accompanying severe somatic disorders. Conclusions: Trans-sulcal approach ensures atraumatic microsurgical access to intracerebral lesions, preserving as much as possible the physiological and anatomical structures of the brain. The surgical intervention creates the least amount of discomfort for the patient and the recovery post-surgical period is fast and with minimum complications.