How to use neuronavigation for the brain

Navigation refers to a device that indicates the location of an individual and the direction where the individual wants to go. Neuronavigation is the application of navigation to neurosurgery, as information on the location of the lesion and the direction to safely approach the lesion is necessary to improve the surgical outcome. Neuronavigation systems have continued to advance in accuracy and convenience and are now standardized and essential. Neuronavigation provides information on the precise localization and delineation of lesions during surgery using registered images. Such devices are most useful in brain tumor surgery and used in almost all neurosurgical operations. However, since preoperative images are used, neuronavigation does not consider real-time information, and errors may occur during or after the registration step [1,2]. Moreover, if surgeons rely too much on neuronavigation and lack understanding of the system’s principles and errors, surgery may become more difficult. There are two systems of neuronavigation: frame-based system and frameless system. We describe the principles, methods of use, pitfalls, and errors of the widely used frameless neuronavigation system.