Application of computer-aided image reconstruction and image guide in parasagittal meningioma resection

Background In recent years, smaller-sized (diameter < 2.5 cm) meningiomas are diagnosed due to increased cranial imaging. Symptomatic meningiomas need to be removed surgically. Therefore, it is extremely important to locate the lesion exactly to tailor the craniotomy especially if the neuro-navigation system is not available. Many hospitals located in the underdeveloped countries cannot afford the high costs of neuro-navigation equipment. Hence, it is relevant to discover low-cost associated and effective methods for lesion localization for surgery. Methods The use of localization markers in advance can help to acquire preoperative CT images of the patients to create and calculate a three-dimensional (3D) virtual graph using a computer. With the 3D graph, spatial distance of the tumor from the markers is calculated and the tumor location projected on the scalp by the Triangle Pythagorean theorem. This enables precise localization of intracranial microlesions preoperatively. Results The location of the tumor was consistent with that of the pre-operative virtual image, and the craniotomy was exact. The patient was discharged 3 days later without any neurological deficits. Conclusions This method is simple and reliable, inexpensive, and accurate in the location of small-sized lesions, which can partially compensate for the lack of neuro-navigation and is suitable for widespread application in hospitals in developing countries.