Craniomapper: An Accurate 2D Plane in Localizing Lesion during Craniotomy

Background: Localizing lesions in the brain while marking for craniotomy is sometimes considered a difficult task. Many times we miss the margin by a few millimeters, which lead to the use of excessive brain retraction and/or bone resection. This is particularly true in high convexity areas where the landmarks are obscured and reference bony points are far. Objective: The objective of this study is to judge the efficacy of Craniomapper in localizing intracranial lesions. Patients and Methods: Craniomapper is an external plastic frame embedded with radio opaque markers placed around the patient head during CT scanning. This craniomapper was used in thirty two patients suffering from high convexity intracranial lesions with computed tomography scanning for better and easy localization of the lesion. Results: Thirty two patients were included in this study. Twenty one patients suffered from intracerebral hemorrhage and other eleven patients suffered from high convexity tumors. This new device gives the surgeon perfect lesional localization by scalp marking. There were no lesional boundaries in all studied patients that need extra bony removal or more brain retraction. The more precise localization provided thereby facilitated planning and performance of surgery. Conclusion: Craniomapper is rapid, simple and inexpensive CT technique for marking the scalp in patients with high cerebral convexity lesions. It is safe to use this Craniomap frame and needs no special training. It is also not costly and can address the issue, where image guidance and or stereotactic systems are not available