The use of stereotactic MRI-guided laser interstitial thermal therapy for the treatment of pediatric cavernous malformations: the SUNY Upstate Golisano Children's Hospital experience.

Autor: De Witt ME; Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, 13210, USA. Dewittm@upstate.edu., Almaguer-Ascencio M; Department of Neurosurgery, Hospital Civil of Guadalajara 'Dr Juan I. Menchaca', University of Guadalajara, Guadalajara, Mexico., Petropoulou K; Department of Neuroradiology, SUNY Upstate Medical University, Syracuse, NY, USA., Tovar-Spinoza Z; Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2023 Feb; Vol. 39 (2), pp. 417-424. Date of Electronic Publication: 2022 Nov 22.
DOI: 10.1007/s00381-022-05701-6
Abstrakt: Purpose: Cavernous malformations (CM) are central nervous system lesions characterized by interlaced vascular sinusoids coated with endothelial cells without intervening parenchyma. Magnetic resonance imaging-guided laser interstitial thermal therapy (MRIgLITT) is a minimally invasive treatment modality that can precisely treat pathologic cerebral tissue, making it an effective alternative for the management of cavernomas. We describe the outcomes of a series of pediatric patients with cavernous brain malformations treated with MRIgLITT between 2014 and 2018 at our institution.
Methods: We retrospectively analyzed 11 cavernomas in 6 pediatric patients treated with MRIgLITT. Both the Visualase System ® and/or Neuroblate ® systems were used. A variation of the surgical technique on the application of the laser was developed. Post-ablation MRIs were obtained to assess ablated areas.
Results: A total of 11 cavernomas in 6 patients were treated with MRIgLITT. Median age was 15 years (12 to 17 years); 75% were males. Presenting symptoms were headache (75%) and seizures (25%). Two patients presented with multiple CMs. All lesions in this study were supratentorial (cerebral hemispheres 81.8%, corpus callosum 9.1%, basal ganglia 9.1%). Our surgical technique was well-tolerated, with no significant adverse events observed. Hospital stay for all patients was less than 48 hours.
Conclusion: MRIgLITT is an effective minimally invasive technique for the treatment of pediatric CMs. It represents a useful and safe tool, when other therapeutic alternatives may represent a greater risk of surgical morbidity.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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