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      Accurate multi-robot targeting for keyhole neurosurgery based on external sensor monitoring

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          Principal Component Analysis

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            Epilepsy surgery in children: results and predictors of outcome on seizures.

            To retrospectively analyze the results on seizures of surgery in children with drug-resistant focal epilepsy. To identify the factors predicting seizure control among several presurgical, surgical, and postsurgical variables. One hundred thirteen patients (67 male, 46 female), younger than 16 years, operated on from 1996 to 2004 and followed-up for at least 2 years were identified. Individualized microsurgical resections, aimed at removal of the epileptogenic zone, were performed according to the results of tailored presurgical evaluations, which included stereo-electroencephalographic recording with intracerebral electrodes when needed. Risk of seizure recurrence was assessed for the considered variables by bivariate and multivariate analysis. Mean age at surgery was 8.8 years, mean duration of epilepsy was 5.7 years, and mean age at seizure onset was 3.1 years. One hundred eight patients (96%) had an abnormal magnetic resonance imaging. At postoperative follow-up (mean duration 55.1 month), 77 patients (68%) were in Engel's class I, with 68 patients (60%) being seizure free (Engel's classes Ia and Ic). At multivariate analysis, variables associated with a significantly lower risk of seizure recurrence were unifocal lesion at MRI and older age at seizure onset (presurgical variables), temporal unilobar resection and complete lesionectomy (surgical variables), diagnosis of glial-neuronal tumors (postsurgical variables). Surgery is a valuable option for children with drug-resistant focal epilepsies which may provide excellent results in a considerable amount of cases. Since results of surgery for epilepsy strongly depend on the presurgical identification of the Epileptogenic Zone, future work should be focused on refinement and implementation of diagnostic strategies.
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              An integrated system for planning, navigation and robotic assistance for skull base surgery.

              We developed an image-guided robot system to provide mechanical assistance for skull base drilling, which is performed to gain access for some neurosurgical interventions, such as tumour resection. The motivation for introducing this robot was to improve safety by preventing the surgeon from accidentally damaging critical neurovascular structures during the drilling procedure.
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                Author and article information

                Journal
                Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine
                Proc Inst Mech Eng H
                SAGE Publications
                0954-4119
                2041-3033
                April 16 2012
                May 2012
                April 16 2012
                May 2012
                : 226
                : 5
                : 347-359
                Affiliations
                [1 ]Bioengineering Department, Neuroengineering and Medical Robotics Laboratory, Politecnico di Milano, Italy
                [2 ]Department of Mechanical Engineering, Technion - Israel Institute of Technology, Israel
                [3 ]Istituto di Tecnologie Industriali ed Automazione, Consiglio Nazionale delle Ricerche, Italy
                Article
                10.1177/0954411912442120
                © 2012

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