Avoidance of Major Vascular Injury in Transcranial Brain Tumor Surgery Using Real-Time Doppler Navigation: Technical Note and Case Series

Objective: In endoscopic endonasal surgery, the Doppler probe has proven useful for localizing the paraclival and cavernous internal carotid arteries (ICA) and avoiding ICA injury. Similarly, during transcranial brain tumor removal, the Doppler may help avoid major arterial or venous injury, particularly for tumors encasing or adherent to Circle of Willis branches and major tributaries. Herein we describe the technique, outcomes and potential neurovascular benefits of real-time navigation using the Doppler during craniotomy for brain tumor removal.