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Introduction of a newly created AW stereotactic frame: a phantom-based accuracy evaluation and an initial experience in clinical usage

Lau BL, Idris Z, Abdullah JM, Bujang MA, Wong ASH

Br J Neurosurg, 2023 Dec;37(6):1572-1579.
PMID: 33191803 DOI: 10.1080/02688697.2020.1837728

BACKGROUND: A new stereotactic frame was created in 2015, based on a linear algorithm. It is called Albert Wong (AW) frame. A simple AW stereo-calculator was also designed based on Excel® (Microscoft Corporation, Redmond, WA) programme for the frame.
OBJECTIVE: The aim of this study is to test the accuracy of the AW frame by a direct head to head comparison with CRW® frame (Integra Life Sciences, Plainsboro, NJ) on a phantom.
METHODS: This is a prospective pilot cross-sectional phantom study with a total of 42 (21 for AW and 21 for CRW®) laboratory testings performed in 2017 at our institute to compare the accuracies of both frames in a consecutive manner. A phantom (BL phantom) was newly created, where targets can be placed at different heights and positions on a platform attached under the frame for accuracy testing comparing between the AW and CRW® frames.
RESULTS: A comparable accuracy testing results were observed between the AW and CRW® frames of 0.64 mm versus 1.07 mm respectively. Approval from the local ethics committee for a clinical trial was obtained. We report on three case illustrations who had the AW frame-based biopsies with definitive diagnoses and without any post-biopsy related complication.
CONCLUSION: AW frame successfully demonstrated a good accuracy of 0.64 mm in phantom testing using the BL phantom by a linear algorithmic calculation. The clinical trial with three patients demonstrated definitive diagnoses and safety with its use.

Matched MeSH terms: Stereotaxic Techniques*
Fulltext Robotic neurosurgery: a preliminary study using an active vision-guided robotic arm for bone drilling and endoscopic manoeuvres

Awang MS, Abdullah MZ

Malays J Med Sci, 2011 Apr;18(2):53-7.
PMID: 22135587 MyJurnal

Surgical robots have been appearing in operating rooms over the past decade, and neurosurgery has been one of the pioneers in this area. In neurosurgery, the clinical use of robots has been limited to stereotactic procedures and endoscopic manoeuvres, although the brain is a unique organ and well-suited for robotic application. The aim of this study was to assess the ability of our vision-guided robotic system to perform basic neurosurgical procedures.

Matched MeSH terms: Stereotaxic Techniques
The development of Stereo-Electroencephalography (SEEG) in Southeast Asia and Oceania: Challenges to equity across the region

Fong MWK, Lim KS, Fong SL, Chen C, Kwan SY, Lee CC, et al.

Neurophysiol Clin, 2025 Jan;55(1):103033.
PMID: 39644808 DOI: 10.1016/j.neucli.2024.103033

BACKGROUND: Invasive/ intracranial EEG forms an important component of assessment for epilepsy surgery in many patients with Drug-Resistant Epilepsy (DRE). Intracranial EEG has been poorly utilized though Southeast Asia (SEA) and Oceania. This study aimed to document the development of stereo-EEG (SEEG) across the region and highlight regional barriers to utilization and access.
METHODS: A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.
RESULTS: Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.
CONCLUSION: The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.

Matched MeSH terms: Stereotaxic Techniques
Spontaneous intracerebral hemorrhage in northeast Malaysian patients: a four-year study

Muiz AJ, Abdullah J, Naing NN, Ghazaime G, Ariff AR

Neuroepidemiology, 2003 May-Jun;22(3):184-95.
PMID: 12711851

The aim of this study was to compare nonsurgical versus stereotactic aspiration of intracerebral hematomas in relation to clinical aspects, computed tomographic imaging features of the brain, laboratory parameters and specific risk factors that may influence the outcome in southeast Asian Malay patients. Fifty-five of the patients with intracerebral hemorrhage (ICH) underwent stereotactic aspiration and 57 did not. Analysis was done on risk factors, locations and treatments of ICH, and the final outcomes measured by the Glasgow Outcome Scale. A total of 112 patients were evaluated. Mean age was 52 years with ages ranging from 12 to 80 years. Hypertension was seen in 60.7% of patients with ICH. The mortality rate was 25% by 3 months. 58.9% had a poor final outcome, while 41.1% had a good outcome. The selected variables were incorporated into models generated by multiple logistic regression method analysis to define the significant predictors of outcome. Significant predictors of outcome were the Glasgow Coma Scale score on admission, the duration of surgery and the total volume of the hematoma. Significant predictors of mortality were high total white blood cell differential count, low plasma protein, and high plasma lactate dehydrogenase and brain edema. The study suggests that stereotactic aspiration of patients with ICH does not offer any definite advantage over conservative treatment.

Matched MeSH terms: Stereotaxic Techniques
Effect of normabaric hyperoxia treatment on neuronal damage following fluid percussion injury in the striatum of mice: a morphological approach

Muthuraju S, Pati S, Rafiqul M, Abdullah JM, Jaafar H

J Biosci, 2013 Mar;38(1):93-103.
PMID: 23385817

Traumatic brain injury (TBI) causes significant mortality in most developing countries worldwide. At present, it is imperative to identify a treatment to address the devastating post-TBI consequences. Therefore, the present study has been performed to assess the specific effect of immediate exposure to normabaric hyperoxia (NBO) after fluid percussion injury (FPI) in the striatum of mice. To execute FPI, mice were anesthetised and sorted into (i) a TBI group, (ii) a sham group without injury and (iii) a TBI group treated with immediate exposure to NBO for 3 h. Afterwards, brains were harvested for morphological assessment. The results revealed no changes in morphological and neuronal damage in the sham group as compared to the TBI group. Conversely, the TBI group showed severe morphological changes as well as neuronal damage as compared to the TBI group exposed to NBO for 3 h. Interestingly, our findings also suggested that NBO treatment could diminish the neuronal damage in the striatum of mice after FPI. Neuronal damage was evaluated at different points of injury and the neighbouring areas using morphology, neuronal apoptotic cell death and pan-neuronal markers to determine the complete neuronal structure. In conclusion, immediate exposure to NBO following FPI could be a potential therapeutic approach to reduce neuronal damage in the TBI model.

Matched MeSH terms: Stereotaxic Techniques