MRI-guided laser interstitial thermal therapy in an infant with tuberous sclerosis: technical case report
| Autor: | Mohamad A. Mikati, Carrie R. Muh, Kristopher G Hooten, Klaus Werner |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Brain Edema Magnetic Resonance Imaging Interventional Stereotaxic Techniques 03 medical and health sciences Tuberous sclerosis Epilepsy Postoperative Complications 0302 clinical medicine Laser Interstitial Thermal Therapy Tuberous Sclerosis Ablative case medicine Humans Craniotomy business.industry Age Factors Infant General Medicine medicine.disease Ablation Skull medicine.anatomical_structure 030220 oncology & carcinogenesis Stereotaxy Female Laser Therapy Radiology business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurosurgery: Pediatrics. 23:92-97 |
| ISSN: | 1933-0715 1933-0707 |
| DOI: | 10.3171/2018.6.peds1828 |
| Popis: | Cortical tubers associated with tuberous sclerosis complex (TSC) are potential epileptic foci that are often amenable to resective or ablative surgeries, and controlling seizures at a younger age may lead to improved functional outcomes. MRI-guided laser interstitial thermal therapy (MRgLITT) has become a popular minimally invasive alternative to traditional craniotomy. Benefits of MRgLITT include the ability to monitor the ablation in real time, a smaller incision, shorter hospital stay, reduced blood loss, and reduced postoperative pain. To place the laser probe for LITT, however, stereotaxy is required—which classically involves head fixation with cranial pins. This creates a relative minimum age limit of 2 years old because it demands a mature skull and fused cranial sutures. A novel technique is presented for the application of MRgLITT in a 6-month-old infant for the treatment of epilepsy associated with TSC. To the authors’ knowledge this is the youngest patient treated with laser ablation. The authors used a frameless navigation technique with a miniframe tripod system and intraoperative reference points. This technique expands the application of MRgLITT to younger patients, which may lead to safer surgical interventions and improved outcomes for these children. |
| Databáze: | OpenAIRE |
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