70557 Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material

Name of the Procedure:

Magnetic Resonance Imaging (MRI) of the Brain during Open Intracranial Procedure (including Brain Stem and Skull Base), without Contrast Material

Summary

This procedure uses MRI technology to capture detailed images of the brain, brain stem, and skull base during an open intracranial surgery. It helps surgeons assess for any remaining tumor or vascular malformation without the use of contrast material.

Purpose

• Addresses: Residual tumor or vascular malformation detection.
• Goals: Ensure complete removal of abnormal tissue and enhance surgical precision. Assess the success of the open intracranial procedure.

Indications

• Symptoms/Conditions: Brain tumors, aneurysms, arteriovenous malformations, during open brain surgery.
• Patient Criteria: Individuals undergoing open cranial surgery where thorough examination and removal of abnormal tissue are critical.

Preparation

• Pre-Procedure Instructions: May include fasting or medication adjustments as per the surgical protocol.
• Diagnostic Tests: Pre-surgery MRI scans, blood tests, and medical assessments.

Procedure Description

1. Patient is placed under general anesthesia.
2. Surgical opening of the skull (craniotomy) is performed.
3. MRI-compatible instruments are used.
4. Intraoperative MRI scanner is used to capture real-time images.
5. Images are reviewed to identify any residual tumor or vascular malformation.
6. Surgeons make adjustments based on MRI findings.
7. Craniotomy is closed and the patient is taken out of anesthesia.

Duration

• Typically ranges from 2 to 6 hours, depending on the complexity of the case.

Setting

• Hospital operating room with specialized intraoperative MRI capabilities.

Personnel

• Surgeons specializing in neurosurgery, radiologists, anesthesiologists, MRI technologists, and operating room nurses.

Risks and Complications

• Common Risks: Infection, bleeding, reaction to anesthesia.
• Rare Risks: Neurological deficits, MRI machine malfunction.

Benefits

• Provides real-time imaging, improving surgical accuracy.
• Increases chances of complete tumor or malformation removal, reducing the need for additional surgeries.
• Reduces the risk of residual disease.

Recovery

• Post-Procedure: Monitoring in a recovery room or ICU.
• Instructions: Gradual return to normal activities, medication management, wound care.
• Follow-Up: MRI scans and neurosurgical evaluations.

Alternatives

• Preoperative MRI with postoperative imaging follow-up.
• Pros: Less intraoperative time.
• Cons: Higher risk of incomplete removal of abnormalities, possibly leading to additional surgeries.

Patient Experience

• During: Patient is under anesthesia and will not feel anything.
• After: Expected to experience some post-surgical pain and discomfort managed with medications.
• Recovery: Gradual, with close medical supervision and instructions to ensure safe recovery.