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1 results

  • Chapter 19 - Combined Keyhole Craniotomies for Multifocal or Multiple Lesions

  • from Section II - Open Combined Approaches
  • Edited by Vijay Agarwal
  • Book:
    Integrated Management of Complex Intracranial Lesions
    Published online:
    05 October 2021
    Print publication:
    21 October 2021, pp 196-202

  • Summary

    It has been well established that surgical resection in patients with singular symptomatic brain metastases prolongs survival. However, surgical resection for patients with multiple symptomatic brain metastases is less commonly performed and reported in the literature, and even avoided, for a multitude of reasons. However, the advent of minimally invasive keyhole techniques has allowed for an increased survival benefit from simultaneous resections of multifocal or multiple lesions, without increasing morbidity. These keyhole techniques have improved the quality of life in patients with multiple lesions by increasing the total extent of resection, which has been shown to correlate with overall patient survival, while minimizing recovery and morbidity. This chapter details the patient selection criteria, preoperative planning, surgical technique, steps for complication avoidance, and postoperative considerations necessary for developing an appropriate treatment plan utilizing multiple keyhole craniotomies in a single surgical setting.