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Case Reports in Neurological Medicine
Volume 2014, Article ID 853425, 7 pages
Case Report

Usefulness of Preoperative Surgical Simulation with Three-Dimensional Fusion Images for Resection of Cerebral Cavernous Malformations Near Broca’s Area

1Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Ohta-machi 366, Gunma, Isesaki 372-0006, Japan
2Hiraga Neurosurgical Clinic, Gunma, Tamamura 370-1124, Japan
3Department of Neurology, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Gunma, Isesaki 372-0006, Japan

Received 14 December 2013; Accepted 20 January 2014; Published 14 April 2014

Academic Editors: S. D. Chang and I. L. Simone

Copyright © 2014 Satoshi Takahashi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Treating subcortical brain lesions in or near eloquent areas is challenging not only because lesions must be resected while preserving brain tissue involved in essential functions, but also because lesions often cannot be easily identified from the surface of the brain. Here, we report 2 cases of cerebral cavernous malformations near Broca’s area. In both cases, lesions were surgically removed by utilizing three-dimensional fusion images created using preoperative magnetic resonance imaging and computed tomography data. Excisions were completed without any worsening of speech function, and the use of presurgical simulations was found to be useful in the design and execution of the actual operations. The technique described in this report serves as a useful tool in simulating surgical strategies by using brain gyri and sulci as surgical landmarks. Furthermore, in contrast to other intraoperative techniques, this method can aid in shortening the duration of surgery and can help limit damage to eloquent areas of the brain.