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Cranial Navigation Application

Detailed Visualization. Intuitive Control.

Brainlab neuronavigation combines ease of use with extended functionality tailored to the surgeons’ needs

Brainlab Cranial Navigation
Touchless surface matching registration with Z-touch®

Time-Saving Registration

Regardless of the patient’s position, Brainlab Cranial Navigation offers multiple techniques for referencing them to the system. Z-touch® and Softouch® are based on surface matching, making patient registration quick and easy by simply touching the patients’ skin with either a pointer or a laser. As both devices register CT and MR images without headsets or markers, registration scans can be avoided, helping to reduce neuronavigation costs and radiation exposure to the patient and O.R. team.

  • Pointer registration with or without markers
  • Touch-sensitive surface matching with Softouch
  • Contact-free surface matching with Z-touch
  • Combined surface matching registration
  • Pre- and intraoperative landmark registration

Touch-sensitive surface matching registration with Softouch®

Detailed visualization of relevant anatomical information in one dedicated view

Approach Planning

Informed approach planning requires consolidated clinical data. Cranial Navigation summarizes relevant and detailed anatomical information in one dedicated view helping surgeons identify their optimal craniotomy before making the incision.

  • Automatic segmentation of skin, bone, cortical vessels and cerebrum
  • 3D preview of the lesion and critical structures before opening the skull
  • Virtual scalpel simulates craniotomy and creates a bone flap object that can be saved for documentation
  • Approach planning in 3D and correlated inline or axial, coronal, sagittal navigation views provides spatial orientation
Dynamic 3D view provides context around the tool tip to help with orientation

Easy-to-use Navigation

When navigating, distraction-free concentration is essential. Detailed visualizations are tailored to show only clinically relevant data, allowing the surgeon to focus on what’s necessary for their work. Optimization of displayed data through automated functions like data selection and layout composition reduce screen interaction, making Cranial Navigation even more user-friendly.¹

  • Smart Approach view dynamically adapts and zooms according to resection progress
  • Overlay mode with fused CT and ultrasound data consolidates relevant anatomical details
  • Dynamic 3D view provides 3D context around the tool tip to help with orientation
  • Smart layout automatically displays optimal patient data in the most suitable layout
Combination of co-registered angiography pairs and MR reconstructions unites blood flow and anatomical information

Vascular Navigation

Cranial Navigation Angio2, 3 lets surgeons easily identify feeding and draining veins on navigated digital subtraction angiography (DSA) data or locate a nidus object with dedicated view layouts. Based on a co-registration of angiographies and subsequent neurovascular contouring it helps to improve orientation and adds clinical context from anatomical 3D data.¹

  • Combines co-registered angiography pairs and navigated MR/CT reconstructions
  • Interactively displays dynamic color-coded contrast flow projections to assist with surgical target identification and analysis
  • Visualizes 2D DSA data as Color Intensity Projection (CIP) to help identify feeding and draining vessels
  • Displays nidus object on navigation data
Navigation-ready pre-calibrated Disposable Stylet

Navigated Disposable Stylet

The Disposable Stylet is designed for the navigated placement of shunts or ventricular catheters in neurosurgery, enabling their quick and easy freehand placement. The incorporated passive marker geometry is automatically recognized by the navigation camera, allowing for instant calibration.

  • Navigation-ready pre-calibrated tool
  • Shunt/catheter vendor independent
  • 1.1 mm diameter, 165 mm length
Cirq Robotic Alignment Module Cranial

Robotic Biopsy Alignment

The Cirq alignment software facilitates intuitive manual arm positioning while the robotic module performs automatic trajectory alignment.4 Trajectories can conveniently be defined using Elements Trajectory Planning or the on-the-fly instrument offset acquisition within Cranial Navigation.

  • Automatic alignment to planned biopsy trajectory after manual arm positioning
  • Cirq Alignment Software provides visual guidance towards region of interest
  • Special biopsy anchor for the skull adds stability to the setup
VarioGuide frameless universal instrument holder and pre-calibrated Disposable Biopsy Needle

VarioGuide Alignment

Surgeons can confidently target pre-planned trajectories with Brainlab VarioGuide®. This frameless universal instrument holder offers continuous position feedback and precise step-by-step workflow guidance for shunt placement and endoscope guidance. For navigated biopsy, pre-planned trajectories can be quickly reached with the disposable pre-calibrated Biopsy Needle.

  • Bridges gap between head frame and freehand
  • Flexibly adapts to various instrument sizes (Ø 1.8 – 8 mm)
  • Disposable Biopsy Needle (Ø 1.8 mm) quickly reaches targets in frameless neurosurgical biopsy procedures
  • Pre-calibrated needle design seamlessly integrates into navigation workflow
Microscope Navigation visualizes the planned surgical target and surrounding structures as semi-transparent volumes mixed with the anatomy seen.

Augmented Reality Visualizations

Augmented reality has become an essential technology in neurosurgery, virtually showing surgeons what lies beneath the surface. Microscope Navigation digitally overlays the planned surgical target and surrounding structures as semi-transparent objects onto the real patient anatomy. These visualizations provide anatomical insight and spatial orientation throughout the procedure.

  • Provides meaningful context about the surgical situation without having to look away from it
  • Maintains navigation accuracy and corrects initial patient registration based on anatomical landmarks
  • Navigation-controlled robotic movement supports ergonomic and efficient alignment to navigated instruments and anatomical landmarks
  • Seamlessly integrates with all major surgical microscope vendors
  • Auto-detects connected microscopes, minimizing setup effort¹
Easy comparison of intraoperative 3D ultrasound overlay with preoperative data in axial, coronal and sagittal reconstructions

Live Intraoperative Imaging

Ultrasound Navigation provides real-time intraoperative imaging that complements cranial image guidance. With a small footprint and minimal interruption of the surgical workflow compared to other imaging modalities, it’s a suitable addition for almost every neurosurgical suite.  

  • Overlays real-time ultrasound images in 2D or 3D
  • Provides accurate orientation as well as updates on resection progress
  • Allows for visualization and assessment of brain shift
  • 3D scanning of the cavity helps identify residual tumor and helps achieve the planned extent of resection
Navigation on intraoperatively acquired and automatically registered patient data

Automatic Image Registration

Automatic Image Registration (AIR) is the fundamental technology for seamless integration of intraoperative MRI or CT images with image guided surgery. AIR adds intraoperatively acquired data to surgical navigation, optimizing the workflow while maintaining the preoperative surgical plan.

  • Eliminates need to access anatomical landmarks
  • Accurate image registration
  • Available for various MR scanners
  • Universal integration of CT, rotational angiograph and cone-beam CT5



Compared to previous version: Cranial/ENT


Requires Elements Planning Application


FDA clearance pending


Commercial availability pending in the USA


Technical feasibility determined on case-by-case basis