Medical & Biological Engineering & Computing

, Volume 51, Issue 3, pp 331–341 | Cite as

Intraoperative forces and moments analysis on patient head clamp during awake brain surgery

  • Danilo De Lorenzo
  • Elena De Momi
  • Lorenzo Conti
  • Emiliano Votta
  • Marco Riva
  • Enrica Fava
  • Lorenzo Bello
  • Giancarlo Ferrigno
Original Article


In brain surgery procedures, such as deep brain stimulation, drug-resistant epilepsy and tumour surgery, the patient is intentionally awakened to map functional neural bases via electrophysiological assessment. This assessment can involve patient’s body movements; thus, increasing the mechanical load on the head-restraint systems used for keeping the skull still during the surgery. The loads exchanged between the head and the restraining device can potentially result into skin and bone damage. The aim of this work is to assess such loads for laying down the requirements of a surgical robotics system for dynamic head movements compensation by fast moving arms and by an active restraint able to damp such actions. A Mayfield® head clamp was tracked and instrumented with strain gages (SGs). SG locations were chosen according to finite element analyses. During an actual brain surgery, displacements and strains were measured and clustered according to events that generated them. Loads were inferred from strain data. The greatest force components were exerted vertically (median 5.5 N, maximum 151.87 N) with frequencies up to 1.5 Hz. Maximum measured displacement and velocity were 9 mm and 60 mm/s, with frequencies up to 2.8 Hz. The analysis of loads and displacements allowed to identify the surgery steps causing maximal loads on the head-restraint device.


Awake brain surgery Force sensors Intraoperative force/moments measurement Head clamp Head rest Motion compensation 



This work was supported by the EU Project Grant ACTIVE FP7-ICT-2009-6-270460. Authors would like to thank Elisa Beretta for her precious help during the experimental setup preparation.


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Copyright information

© International Federation for Medical and Biological Engineering 2012

Authors and Affiliations

  • Danilo De Lorenzo
    • 1
  • Elena De Momi
    • 1
    • 2
  • Lorenzo Conti
    • 1
  • Emiliano Votta
    • 1
  • Marco Riva
    • 3
  • Enrica Fava
    • 3
  • Lorenzo Bello
    • 3
  • Giancarlo Ferrigno
    • 1
  1. 1.Bioengineering DepartmentPolitecnico di MilanoMilanItaly
  2. 2.Istituto di Tecnologie Industriali ed AutomazioneConsiglio Nazionale delle RicercheMilanItaly
  3. 3.Neurochirurgia, Istituto Clinico Humanitas, IRCCSUniversità degli studi di MilanoRozzanoItaly

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