Fiber tractography : Safe Technology Used In Brain Surgery

Dr. Nopasin Thakhingdech

Neurosurgery

     In the past, the thought of brain surgery was frightening, often associated with the risk of disability. Today, advanced technology has made it much safer. For example, using MRI with fiber tractography allows surgeons to visualize the brain's important nerve fiber pathways. This is a significant improvement over traditional imaging, which only shows brain tissue without revealing which areas are critical.

What are Nerve Fiber Tracts?

     Nerve fiber tracts are like the body's electrical wires, connecting different parts of the brain and sending signals to other organs. For instance, when you want to move, a signal travels along these tracts to the muscles. Damaging these tracts can impair movement.

How Does Fiber Tractography Help Surgeons?

     Many brain diseases, such as tumors or strokes, can compress or damage nerve tracts. While the brain has a high degree of adaptability (known as brain plasticity), surgeons need to know the location of these tracts to plan an accurate and safe operation. Fiber tractography helps them avoid damaging these critical pathways, reducing the risk of disability for the patient.

The rest of the text describes example images from a real patient at Ramkhamhaeng Hospital, illustrating the following points:

• Normal MRI: Does not show nerve fiber tracts.
• Fiber Tractography: Shows tracts in different colors, indicating their direction (vertical, horizontal, or transverse).
• Example 1 (Stroke): An image shows a blood clot that has compressed and damaged nerve fibers.
• Example 2 (Brain Tumor): An image demonstrates the relationship between a tumor and the surrounding nerve tracts, which helps in surgical planning for a safer procedure.