Feasibility of Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Essential Tremor in the Setting of Prior Craniotomy.
Oper Neurosurg (Hagerstown)
; 22(2): 61-65, 2022 02 01.
Article
en En
| MEDLINE
| ID: mdl-35007218
ABSTRACT
BACKGROUND:
Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy is a rapidly evolving therapy for the treatment of essential tremor. Although the skull is a major determinant of the delivery of acoustic energy to the target, how the presence of a prior craniotomy must be accounted for during lesioning is unclear.OBJECTIVE:
To demonstrate novel application of this therapeutic option in a patient with a history of prior craniotomies for unrelated intracranial pathologies.METHODS:
A 55-yr-old man with a history of right frontal craniotomy for resection of a colloid cyst underwent a left ventrointermedius nucleus thalamotomy through MRgFUS. The prior craniotomy flap was not excluded in the treatment plan; however, all bony defects and hardware were marked as "no-pass" regions. Clinical outcomes were collected at the 6-mo follow-up.RESULTS:
Transducer elements whose acoustic paths would have been altered by the craniotomy defect were turned off. Sonications reaching lesional temperatures of up to 56°C were successfully delivered. The procedure was well-tolerated, without any persistent intra-ablation or postablation adverse effects. The presence of a lesion was confirmed on MRI, which was associated with a significant reduction in the patient's tremor that was sustained at the 6-mo follow-up.CONCLUSION:
This case demonstrates the safety and efficacy of MRgFUS thalamotomy in a patient with prior craniotomies and highlights our strategy for acoustic lesioning in this setting.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Temblor Esencial
Límite:
Humans
/
Male
Idioma:
En
Revista:
Oper Neurosurg (Hagerstown)
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos