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https://www.readbyqxmd.com/read/29570389/anterior-two-thirds-corpus-callosotomy-via-stereotactic-laser-ablation
#1
Michael Karsy, Daxa M Patel, Kyle Halvorson, Vance Mortimer, Robert J Bollo
Anterior two-thirds corpus callosotomy is a common palliative surgical intervention most commonly employed in patients with atonic or drop seizures. Recently, stereotactic laser ablation of the corpus callosum without a craniotomy has shown promise in achieving similar outcomes with fewer side effects and shorter hospitalizations. The authors demonstrate ablation of the anterior two-thirds corpus callosum in a patient with Lennox-Gastaut syndrome and drug-resistant drop seizures. Technical nuances of laser ablation with 3 laser fibers are described...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29570386/laser-interstitial-thermal-therapy-for-an-eloquent-region-supratentorial-brain-lesion
#2
Mayur Sharma, Daria Krivosheya, Hamid Borghei-Razavi, Gene H Barnett, Alireza M Mohammadi
Laser interstitial thermal therapy (LITT) is a minimally invasive stereotactic technique that causes tumor ablation using thermal energy. LITT has shown to be efficacious for the treatment of deep-seated brain lesions, including those near eloquent areas. In this video, the authors present the case of a 62-year-old man with a history of metastatic melanoma who presented with worsening right-sided hemiparesis. MRI revealed a contrast-enhancing lesion in left centrum semiovale in close proximity to corticospinal tracts, consistent with radiation necrosis...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29570385/stereotactic-laser-ablation-of-amygdala-and-hippocampus-using-a-leksell-stereotactic-frame
#3
Ahmed J Awad, Ha S Nguyen, Elsa Arocho-Quinones, Ninh Doan, Wade Mueller, Sean M Lew
Approximately one-third of patients with epilepsy are resistant to medical therapy, particularly in those with mesial temporal lobe epilepsy. While there are several surgical modalities, efforts have been focused on developing safer and minimally invasive techniques. In this video, the authors present the case of a 45-year-old woman with a 2-year history of refractory left mesial temporal lobe epilepsy who underwent MRI-guided laser ablation of amygdala and hippocampus. There were no perioperative complications...
April 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29451455/laser-ablative-therapy-of-sessile-hypothalamic-hamartomas-in-children-using-interventional-mri-report-of-5-cases
#4
Derek G Southwell, Harjus S Birk, Paul S Larson, Philip A Starr, Leo P Sugrue, Kurtis I Auguste
Hypothalamic hamartomas (HHs) are benign lesions that cause medically refractory seizures, behavioral disturbances, and endocrine dysfunction. Open resection of HHs does not guarantee seizure freedom and carries a relatively high risk of morbidity. Minimally invasive stereotactic laser ablation has recently been described as an effective and safe alternative for HH treatment. Prior studies have not, however, assessed HH lesion size and morphology, 2 factors that may influence treatment results and, ultimately, the generalizability of their findings...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29451453/trapped-ventricle-after-laser-ablation-of-a-subependymal-giant-cell-astrocytoma-complicated-by-intraventricular-gadolinium-extravasation-case-report
#5
Michael Karsy, Daxa M Patel, Robert J Bollo
Magnetic resonance imaging-guided stereotactic laser ablation of intracranial targets, including brain tumors, has expanded dramatically over the past decade, but there have been few reports of complications, especially those occurring in a delayed fashion. Laser ablation of subependymal giant cell astrocytomas (SEGAs) is an attractive alternative to maintenance immunotherapy in some children with tuberous sclerosis complex (TSC); however, the effect of treatment on disease progression and the nature and frequency of potential complications remains largely unknown...
February 16, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29444286/techniques-to-ensure-accurate-targeting-for-delivery-of-awake-laser-interstitial-thermotherapy
#6
Dimitri Laurent, Seth F Oliveria, Michael Shang, Frank Bova, Rachel Freedman, Maryam Rahman
BACKGROUND: Magnetic resonance imaging (MRI) guided laser interstitial thermal therapy (LITT) is an emerging neurosurgical treatment modality that is typically performed under general anesthesia. We describe a novel workflow developed at the University of Florida to deliver LITT in conscious patients without the use of general anesthesia. OBJECTIVE: To describe a novel workflow for LITT implementation in the awake patient with equivalent treatment results when compared to procedures performed under general anesthesia...
February 10, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29425986/is-edema-a-matter-of-concern-after-laser-ablation-of-epileptogenic-focus
#7
Vivek Tandon, Michael Lang, Poodipedi Sarat Chandra, Ashwini Sharan, Ajay Garg, Manjari Tripathi
BACKGROUND: A stereotactically placed laser fiber can deliver thermal energy to an epileptogenic focus in brain. This procedure is done under intraoperative (thermography) magnetic resonance imaging (MRI) guidance. Thermoablation can lead to edema in surrounding area and can cause secondary insult. In this case report of three cases, we have quantified the edema produced after laser ablation, with sequential MRI in immediate post-operative period. CASE DESCRIPTION(S): Three patients of intractable epilepsy underwent proper neurological and neuro-radiological workup to localize the site of epileptogenic foci...
February 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29420840/stereotactic-laser-amygdalohippocampotomy-for-mesial-temporal-lobe-epilepsy
#8
Robert E Gross, Matthew A Stern, Jon T Willie, Rebecca E Fasano, Amit M Saindane, Bruno P Soares, Nigel P Pedersen, Daniel L Drane
OBJECTIVE: To evaluate the outcomes one-year and longer following stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy in a large series of patients treated over a five-year period since introduction of this novel technique. METHODS: Surgical outcomes of a consecutive series of fifty-eight patients with mesial temporal lobe epilepsy who underwent the surgery at our institution with at least 12-months follow-up were retrospectively evaluated...
February 8, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29414561/a-modern-epilepsy-surgery-treatment-algorithm-incorporating-traditional-and-emerging-technologies
#9
REVIEW
Dario J Englot
Epilepsy surgery has seen numerous technological advances in both diagnostic and therapeutic procedures in recent years. This has increased the number of patients who may be candidates for intervention and potential improvement in quality of life. However, the expansion of the field also necessitates a broader understanding of how to incorporate both traditional and emerging technologies into the care provided at comprehensive epilepsy centers. This review summarizes both old and new surgical procedures in epilepsy using an example algorithm...
February 1, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29408592/stereotactic-radiofrequency-thermocoagulation-of-hypothalamic-hamartoma-using-robotic-guidance-rosa-co-registered-with-o-arm-guidance-preliminary-technical-note
#10
Vivek Tandon, Poodipedi Sarat Chandra, Ramesh Sharanappa Doddamani, Heri Subianto, Jitin Bajaj, Ajay Garg, Manjari Tripathi
INTRODUCTION: Treatment options for hypothalamic hamartoma (HH) include microvascular surgery, stereotactic radiofrequency thermocoagulation (SRT), laser interstitial thermal therapy (LITT) or Gamma knife surgery (GKS). During SRT, thermographic monitoring cannot be performed and therefore highly accurate placement of electrode and confirmation of its position are required. We have utilized robotic guidance (ROSA) and co-registered it with O-Arm, for performing ablation of hamartoma. METHODS: Five patients of HH with gelastic seizures (GS) underwent SRT...
February 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29372873/a-novel-mesial-temporal-stereotactic-coordinate-system
#11
Kai J Miller, Casey H Halpern, Mark F Sedrak, John A Duncan, Gerald A Grant
OBJECTIVE Stereotactic laser ablation and neurostimulator placement represent an evolution in staged surgical intervention for epilepsy. As this practice evolves, optimal targeting will require standardized outcome measures that compare electrode lead or laser source with postprocedural changes in seizure frequency. The authors propose and present a novel stereotactic coordinate system based on mesial temporal anatomical landmarks to facilitate the planning and delineation of outcomes based on extent of ablation or region of stimulation within mesial temporal structures...
January 26, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29328005/a-novel-use-of-the-neuroblate-sidefire-probe-for-minimally-invasive-disconnection-of-a-hypothalamic-hamartoma-in-a-child-with-gelastic-seizures
#12
James M Wright, Michael D Staudt, Andrea Alonso, Jonathan P Miller, Andrew E Sloan
The authors describe the case of a 22-month-old boy who presented with gelastic seizures and developmental delay. Magnetic resonance imaging and video-electroencephalography monitoring revealed a primarily intraventricular hypothalamic hamartoma and gelastic seizures occurring 20-30 times daily. The patient was treated with various regimens of antiepileptic medications for 16 months, but the seizures remained medically intractable. At 3 years of age, he underwent stereotactic laser ablation with an aim of disconnection of the lesion...
March 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29183959/stereotactic-eeg-guided-laser-interstitial-thermal-therapy-for-mesial-temporal-lobe-epilepsy
#13
James X Tao, Shasha Wu, Maureen Lacy, Sandra Rose, Naoum P Issa, Carina W Yang, Katherine E Dorociak, Maria Bruzzone, Jisoon Kim, Ahmad Daif, Jason Choi, Vernon L Towle, Peter C Warnke
OBJECTIVE: To determine the outcomes of combined stereo-electroencephalography-guided and MRI-guided stereotactic laser interstitial thermal therapy (LITT) in the treatment of patients with drug-resistant mesial temporal lobe epilepsy (mTLE). METHODS: We prospectively assessed the surgical and neuropsychological outcomes in 21 patients with medically refractory mTLE who underwent LITT at the University of Chicago Medical Center. We further compared the surgical outcomes in patients with and without mesial temporal sclerosis (MTS)...
November 28, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29172137/the-impact-of-stereotactic-laser-ablation-at-a-typical-epilepsy-center
#14
Gabrielle T Petito, Robert E Wharen, Anteneh M Feyissa, Sanjeet S Grewal, John A Lucas, William O Tatum
PURPOSE: Stereotactic laser ablation (SLA) is a novel form of epilepsy surgery for patients with drug-resistant focal epilepsy. We evaluated one hundred consecutive surgeries performed for patients with epilepsy to address the impact of SLA on our therapeutic approach, as well as patient outcomes. METHODS: A retrospective, single center analysis of the last one hundred neurosurgeries for epilepsy was performed from 2013 to 2015. Demographics, surgical procedures, and postoperative measures were assessed up to 5years to compare the effect of SLA on outcome...
January 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29140463/anatomic-investigation-of-the-trajectory-for-stereotactic-laser-amygdalohippocampectomy
#15
Vanessa M Holanda, Abuzer Gungor, Serhat Baydin, Erik H Middlebrooks, Shabbar F Danish
BACKGROUND: Magnetic resonance imaging-guided laser interstitial thermal therapy (LITT) has emerged as a promising treatment for mesial temporal lobe epilepsy. Surgeons must understand the relevant anatomy that is traversed by the catheter and affected by ablation. OBJECTIVE: To study the anatomic structures crossed by the LITT catheter until it reaches the amygdala. METHODS: Three human cadaveric heads were implanted with catheters using a frameless stereotactic technique...
November 11, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29111296/a-neurosurgeon-s-view-laser-interstitial-thermal-therapy-of-mesial-temporal-lobe-structures
#16
Yarema B Bezchlibnyk, Jon T Willie, Robert E Gross
Stereotactic laser ablation of mesial temporal structures is a promising new surgical intervention for patients with mesial temporal lobe epilepsy (MTLE). Since this procedure was first used to treat MTLE in 2010, the literature contains reports of 37 patients that underwent MR-guided stereotactic laser amygdalohippocampotomy (SLAH) using Laser Interstitial Thermal Therapy (LITT) with at least 1year of follow-up. This early body of data suggests that SLAH is a safe and effective treatment for MTLE in properly selected patients...
October 27, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28964596/mri-guided-stereotactic-laser-ablation-for-epilepsy-surgery-promising-preliminary-results-for-cognitive-outcome
#17
Daniel L Drane
Cognitive outcome data are reviewed with respect to the use of magnetic-resonance guided stereotactic laser ablation (SLA) as an epilepsy surgical procedure, with comparisons drawn to traditional open resection procedures. Cognitive outcome with stereotactic laser amygdalohippocampotomy (SLAH) appears better than open resection for several functions dependent on extra-mesial temporal lobe (TL) structures, including category-related naming, verbal fluency, and object/familiar person recognition. Preliminary data suggests episodic, declarative verbal memory can decline following SLAH in the language dominant hemisphere, although early findings suggest comparable or even superior outcomes compared with open resection...
September 23, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28917280/a-novel-use-of-the-intraoperative-mri-for-metastatic-spine-tumors-laser-interstitial-thermal-therapy-for-percutaneous-treatment-of-epidural-metastatic-spine-disease
#18
REVIEW
Jonathan G Thomas, Wajd N Al-Holou, Dhiego Chaves de Almeida Bastos, Amol J Ghia, Jing Li, Andrew J Bishop, Behrang Amini, Laurence D Rhines, Claudio E Tatsui
Spinal laser interstitial thermal therapy (LITT) appears to be a promising novel modality for treatment of epidural metastatic spine disease in patients who are poor candidates for larger-scale oncologic spinal surgery and can act synergetically with spinal stereotactic radiosurgery to maximize local control and palliate pain. This technique is ideally suited for the intraoperative MRI suite to monitor the extent of the ablation in the epidural space. As percutaneous navigation, imaging, and LITT technology improve, broader applicability of this minimally invasive technique in spinal oncology is foreseen...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28886982/management-of-epilepsy-due-to-hypothalamic-hamartomas
#19
REVIEW
Ayaz M Khawaja, Sandipan Pati, Yu-Tze Ng
A hypothalamic hamartoma consists of hyperplastic heterotopic tissue growing in a disorganized fashion. These lesions occur in about one per 50,000 to 100,000 people. Hypothalamic hamartomas can cause intrinsic epileptogenesis leading to gelastic seizures. Surrounding cortical structures may also develop secondary epileptogenesis. Persistent seizures caused by hypothalamic hamartomas can be debilitating and result in significant cognitive and behavioral impairment. Early recognition and treatment is important in controlling seizures and in preventing further cognitive deterioration...
October 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28841472/neuropsychological-outcomes-following-stereotactic-laser-amygdalohippocampectomy
#20
Melanie R F Greenway, John A Lucas, Anteneh M Feyissa, Sanjeet Grewal, Robert E Wharen, William O Tatum
OBJECTIVE: The objective was to analyze neuropsychological testing data from 15 patients before and after stereotactic laser ablation surgery for temporal lobe epilepsy and to describe the seizure outcomes after stereotactic laser ablation surgery. METHODS: A retrospective review of 15 patients who underwent stereotactic laser ablation and who also underwent neuropsychological testing before and after surgery was performed. Verbal and visual memory was assessed in all 15 patients using California Verbal Learning Test and Wechsler Memory Scale IV...
August 22, 2017: Epilepsy & Behavior: E&B
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