Hypothalamic Hamartomas: Neuropathological Features with and without Prior Gamma Knife Radiosurgery
| Autor: | Erin C. Prenger, Kristina A. Simeone, John F. Kerrigan, Adib A. Abla, Andrew G. Shetter, Stephen W. Coons, Angela Parsons, Stephen G. Rice |
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| Rok vydání: | 2012 |
| Předmět: |
Male
congenital hereditary and neonatal diseases and abnormalities Pathology medicine.medical_specialty Adolescent Hamartoma medicine.medical_treatment education Gamma knife radiosurgery Cell Count Neuropathology Gamma knife Radiosurgery Young Adult Epilepsy Postoperative Complications Hypothalamic hamartoma medicine Humans Single-Blind Method Epilepsy surgery Gliosis Child Retrospective Studies Cell Nucleus Neurons Cell Death business.industry Infant medicine.disease Combined Modality Therapy surgical procedures operative Child Preschool Anticonvulsants Female Surgery Endothelium Vascular Microglia sense organs Neurology (clinical) Vascular pathology business Nuclear medicine Hypothalamic Diseases |
| Zdroj: | Stereotactic and Functional Neurosurgery. 91:45-55 |
| ISSN: | 1423-0372 1011-6125 |
| DOI: | 10.1159/000341076 |
| Popis: | Background: The neuropathological consequences of Gamma Knife radiosurgery (GK) on hypothalamic hamartoma (HH) are unknown. Objective: In a cohort of patients undergoing surgery for treatment-resistant epilepsy, we compared surgically resected HH tissue from patients without (group I; n = 19) and with (group II; n = 10) a history of GK (median dose 16 Gy to the 50% isodose margin). Methods: Techniques included thick-section stereology for total nucleated and total neuron cell counts, and thin-section immunohistochemistry. Normal human hypothalamus derived from age-matched autopsy material was used as control tissue for CD68 immunohistochemistry. Qualitative scoring of tissue sections was performed by a neuropathologist who was blind to the GK treatment history. Results: GK is associated with decreased total cell density (p < 0.02). A dose-dependent association of GK with decreased total neuron density approached significance (p = 0.06). Group II HH tissue had significantly more (1) reactive gliosis, (2) thickened capillary endothelium and (3) microglial activation. Degenerative features, including karyorrhexis and pyknotic nuclei, were infrequent in group II and absent in group I HH tissue. Conclusions: Nonnecrotizing doses of GK radiosurgery decrease cell density in human HH tissue. Cell loss resulting from GK may contribute to decreased excitation in the neuronal networks responsible for seizure onset in HH tissue. |
| Databáze: | OpenAIRE |
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