1. Interventional MRI–Guided Deep Brain Stimulation Lead Implantation
Philip S. Lee, MD, PhD, Robert Mark Richardson, MD, PhD 
Neurosurgery Clinics 
Volume 28, Issue 4, Pages (October 2017)
DOI: /j.nec
Copyright © 2017 The Author(s) Terms and Conditions

2. Fig. 1
Steps in iMRI-guided DBS lead implantation. (A) The patient is positioned supine and the head is sterilely draped within the MRI bore. MRI-visible marking grids (white arrowhead) are affixed to the scalp. (B) Volumetric scans are obtained and transferred to the ClearPoint planning station (white arrowhead), operated by the surgeon near the MRI console. (C) Instructions from the software are used to align the trajectories, by turning knobs affixed to a skull-mounted guide-frame. (D) When the guide-frame (black arrowhead) has been aligned such that the trajectory has a predicted radial error less than 0.5 mm, a ceramic stylet (white arrowhead) is placed to target depth through a peel-away plastic sheath and a scan is obtained to confirm accurate location. (E) Following stylet removal, a DBS lead (white arrowhead) is placed through the sheath to target depth.
Neurosurgery Clinics  , DOI: ( /j.nec )
Copyright © 2017 The Author(s) Terms and Conditions

3. Fig. 2
Trajectory alignment. Screenshots depicting software feedback during pitch-roll adjustments (A, B) and medial-lateral translation (C, D) during a GPi implantation. Note that the final expected 2-dimensional radial error of alignment was 0.3 mm.
Neurosurgery Clinics  , DOI: ( /j.nec )
Copyright © 2017 The Author(s) Terms and Conditions

4. Fig. 3
An avoidable complication. Example of a subcortical hemorrhage that resulted from inadequate pial opening during ceramic stylet insertion.
Neurosurgery Clinics  , DOI: ( /j.nec )
Copyright © 2017 The Author(s) Terms and Conditions

5. Fig. 4
Assessment of implantation error. Screenshots depicting the assessment step for the same GPi implantation shown in Fig. 2. Note that the final 2-dimensional radial error was 0.6 mm.
Neurosurgery Clinics  , DOI: ( /j.nec )
Copyright © 2017 The Author(s) Terms and Conditions