Early outcomes of stereoelectroencephalography followed by MR-guided laser interstitial thermal therapy: a paradigm for minimally invasive epilepsy surgery.

Abstract:

:OBJECTIVE Stereoelectroencephalography (sEEG) and MR-guided laser interstitial thermal therapy (MRgLITT) have both emerged as minimally invasive alternatives to open surgery for the localization and treatment of medically refractory lesional epilepsy. Although some data are available about the use of these procedures individually, reports are almost nonexistent on their use in conjunction. The authors' aim was to report early outcomes regarding efficacy and safety of sEEG followed by MRgLITT for localization and ablation of seizure foci in the pediatric population with medically refractory lesional epilepsy. METHODS A single-center retrospective review of pediatric patients who underwent sEEG followed by MRgLITT procedures was performed. Demographic, intraoperative, and outcome data were compiled and analyzed. RESULTS Four pediatric patients with 9 total lesions underwent sEEG followed by MRgLITT procedures between January and September 2017. The mean age at surgery was 10.75 (range 2-21) years. Two patients had tuberous sclerosis and 2 had focal cortical dysplasia. Methods of stereotaxy consisted of BrainLab VarioGuide and ROSA robotic guidance, with successful localization of seizure foci in all cases. The sEEG procedure length averaged 153 (range 67-235) minutes, with a mean of 6 (range 4-8) electrodes and 56 (range 18-84) contacts per patient. The MRgLITT procedure length averaged 223 (range 179-252) minutes. The mean duration of monitoring was 6 (range 4-8) days, and the mean total hospital stay was 8 (range 5-11) days. Over a mean follow-up duration of 9.3 (range 5.1-16) months, 3 patients were seizure free (Engel class I, 75%), and 1 patient saw significant improvement in seizure frequency (Engel class II, 25%). There were no complications. CONCLUSIONS These early data demonstrate that sEEG followed by MRgLITT can be used safely and effectively to localize and ablate epileptogenic foci in a minimally invasive paradigm for treatment of medically refractory lesional epilepsy in pediatric populations. Continued collection of data with extended follow-up is needed.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Cobourn K,Fayed I,Keating RF,Oluigbo CO

doi

10.3171/2018.6.FOCUS18209

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

E8

issue

3

issn

1092-0684

pii

2018.6.FOCUS18209

journal_volume

45

pub_type

杂志文章
  • Indications for fusion following decompression for lumbar spinal stenosis.

    abstract::Degenerative lumbar spinal stenosis is a common condition affecting middle-aged and elderly people. Significant controversy exists concerning the appropriate indications for fusion following decompressive surgery. The purpose of this report is to compare the clinical outcomes of patients who were and were not treated ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1997.3.2.5

    authors: Fox MW,Onofrio BM

    更新日期:1997-08-15 00:00:00

  • Topectomy versus leukotomy: J. Lawrence Pool's contribution to psychosurgery.

    abstract::Surgery of the mind has a rather checkered past. Though its history begins with the prehistoric trephination of skulls to allow "evil spirits" to escape, the early- to mid-20th century saw a surge in the popularity of psychosurgery. The 2 prevailing operations were topectomy and leukotomy for the treatment of certain ...

    journal_title:Neurosurgical focus

    pub_type: 历史文章,杂志文章

    doi:10.3171/2017.6.FOCUS17259

    authors: Holland R,Kopel D,Carmel PW,Prestigiacomo CJ

    更新日期:2017-09-01 00:00:00

  • A new trend in operative technique for intracerebral hemorrhage: a comparative study of stereotactic endoscopic removal and stereotactic catheter drainage.

    abstract::The development of less invasive methods to evacuate intracerebral hematomas (ICHs) has improved outcome in patients with traumatic brain injury. Eighteen patients with ICHs underwent surgery via one of two methods: stereotactic endoscopic removal (SER) or stereotactic catheter drainage (SCD). The outcome results were...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1996.1.4.2

    authors: Kim MH,Song JH,Kim SH,Park DB,Shin KM

    更新日期:1996-10-15 00:00:00

  • Cervical spondylotic myelopathy treated with corpectomy: technique and results in 44 patients.

    abstract::Forty-four patients with cervical spondylotic myelopathy who underwent a ventral surgical approach were evaluated with respect to the results of surgery. The neurological status of the patients was categorized according to the modified Japanese Orthopedic Association scale (0-18). Three patients had a functional score...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1996.1.6.6

    authors: Naderi S,Alberstone CD,Rupp FW,Benzel EC,Baldwin NG

    更新日期:1996-12-15 00:00:00

  • Multimodal navigation in the functional microsurgical resection of intrinsic brain tumors located in eloquent motor areas: role of tractography.

    abstract:OBJECT:Nowadays the role of microsurgical management of intrinsic brain tumors is to maximize the volumetric resection of the tumoral tissue, minimizing the postoperative morbidity. The purpose of this paper was to study the benefits of an original protocol developed for the microsurgical treatment of tumors located in...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2009.11.FOCUS09234

    authors: González-Darder JM,González-López P,Talamantes F,Quilis V,Cortés V,García-March G,Roldán P

    更新日期:2010-02-01 00:00:00

  • Revisions for screw malposition and clinical outcomes after robot-guided lumbar fusion for spondylolisthesis.

    abstract::OBJECTIVE The accuracy of robot-guided pedicle screw placement has been proven to be high, but little is known about the impact of such guidance on clinical outcomes such as the rate of revision surgeries for screw malposition. In addition, there are very few data about the impact of robot-guided fusion on patient-rep...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.3.FOCUS16534

    authors: Schröder ML,Staartjes VE

    更新日期:2017-05-01 00:00:00

  • The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States.

    abstract::Spine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentatio...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.8.FOCUS20600

    authors: Sankey EW,Mehta VA,Wang TY,Than TT,Goodwin CR,Karikari IO,Shaffrey CI,Abd-El-Barr MM,Than KD

    更新日期:2020-11-01 00:00:00

  • High flow EC-IC bypass for a giant left MCA aneurysm.

    abstract::Giant cerebral aneurysms may be treated through a variety of options, including aneurysm trapping with concurrent bypass. This video describes the case of a large, recurrent, left middle cerebral artery aneurysm that was treated using a high flow, radial artery bypass graft, from the external carotid artery to the lef...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.V1.FOCUS14548

    authors: Arias EJ,Zipfel GJ

    更新日期:2015-01-01 00:00:00

  • The influence of secondary gain on surgical outcome: a comparison between cervical and lumbar discectomy.

    abstract::Although the expectation of monetary compensation has been associated with failures in lumbar discectomy, the issue has not been investigated in patients undergoing cervical disc surgery. The authors analyzed the relationship between economic forms of secondary gain and surgical outcome in a group of patients with a c...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1998.5.2.9

    authors: Kaptain GJ,Shaffrey CI,Alden TD,Young JN,Whitehill R

    更新日期:1998-08-15 00:00:00

  • Can segmental mobility be increased by cervical arthroplasty?

    abstract::OBJECTIVE Many reports have successfully demonstrated that cervical disc arthroplasty (CDA) can preserve range of motion after 1- or 2-level discectomy. However, few studies have addressed the extent of changes in segmental mobility after CDA or their clinical correlations. METHODS Data from consecutive patients who u...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.10.FOCUS16411

    authors: Chang HK,Chang CC,Tu TH,Wu JC,Huang WC,Fay LY,Chang PY,Wu CL,Cheng H

    更新日期:2017-02-01 00:00:00

  • Wingspan stenting of symptomatic extracranial vertebral artery stenosis and perioperative evaluation using quantitative magnetic resonance angiography: report of two cases.

    abstract::The best management strategy for symptomatic vertebrobasilar ischemia is currently not well-defined. Noninvasive Optimal Vessel Analysis (NOVA, VasSol, Inc.) is computer software that, using quantitative magnetic resonance (MR) angiography technology, represents the only commercially available means of noninvasively m...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/FOC/2008/24/2/E14

    authors: Brisman JL

    更新日期:2008-01-01 00:00:00

  • Complications in adult spinal deformity surgery: an analysis of minimally invasive, hybrid, and open surgical techniques.

    abstract:OBJECT:It is hypothesized that minimally invasive surgical techniques lead to fewer complications than open surgery for adult spinal deformity (ASD). The goal of this study was to analyze matched patient cohorts in an attempt to isolate the impact of approach on adverse events. METHODS:Two multicenter databases querie...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.3.FOCUS13534

    authors: Uribe JS,Deukmedjian AR,Mummaneni PV,Fu KM,Mundis GM Jr,Okonkwo DO,Kanter AS,Eastlack R,Wang MY,Anand N,Fessler RG,La Marca F,Park P,Lafage V,Deviren V,Bess S,Shaffrey CI,International Spine Study Group.

    更新日期:2014-05-01 00:00:00

  • A stepwise illustration of the retrosigmoid approach for resection of a cerebellopontine meningioma.

    abstract::The retrosigmoid approach is a work-horse approach to the cerebellopontine angle (CPA), providing access from the foremen magnum to the tentorium. Indications for this approach are variable such as resection of meningiomas, acoustic neuromas and epidermoid tumors, treatment of vascular lesions of vertebrobasilar syste...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.V1.FOCUS13445

    authors: Cıkla U,Kujoth GC,Başkaya MK

    更新日期:2014-01-01 00:00:00

  • Thoracoscopic surgery: historical perspectives.

    abstract::Recent technical advances have revolutionized the fields of surgical endoscopy, laparoscopy, thoracoscopy, and microsurgical spinal endoscopy. The authors discuss the rich history and recent evolution of these techniques. Thoracoscopy had been widely used for the treatment of pleural conditions associated with tubercu...

    journal_title:Neurosurgical focus

    pub_type: 历史文章,杂志文章

    doi:10.3171/foc.2000.9.4.10

    authors: Das K,Rothberg M

    更新日期:2000-10-15 00:00:00

  • Contralateral C-7 transfer: is direct repair really superior to grafting?

    abstract::It is not uncommon for a severe traumatic brachial plexus injury to involve all 5 roots, resulting in a flail upper limb. In such cases, surgical reconstruction is often palliative, providing only rudimentary function. Nerve transfers are the mainstay of reconstructive strategies due to the predominance of root avulsi...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.4.FOCUS1794

    authors: Bhatia A,Doshi P,Koul A,Shah V,Brown JM,Salama M

    更新日期:2017-07-01 00:00:00

  • Introduction: military neurosurgery, past and present.

    abstract::For a physician has the worth of many other warriors, both for the excision of arrows and for the administration of soothing drugs. Homer, Iliad XI.514-515 Ever since armed conflict has been used as a means to settle disputes among men, there have been those who have been tasked to mend the wounds that ravage a soldie...

    journal_title:Neurosurgical focus

    pub_type: 历史文章

    doi:10.3171/2010.3.FOCUSMar2010Intro

    authors: Klimo P Jr,Ragel BT

    更新日期:2010-05-01 00:00:00

  • Leiomyosarcomatous transformation of unknown pediatric primary brainstem lesion following radiotherapy. Case report.

    abstract::Primary leiomyosarcoma of the central nervous system is rare and has been described both de novo and following temporally remote radiotherapy for a different unrelated malignancy. The authors report the case of a 42-year-old man in whom 60Co radiation treatment had been performed for an unknown primary mass in the bra...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2002.12.6.13

    authors: Yeh DJ,Hessler RB,Lee MR

    更新日期:2002-06-15 00:00:00

  • Peroneal nerve injury associated with sports-related knee injury.

    abstract:OBJECT:This study analyzes 84 cases of peroneal nerve injuries associated with sports-related knee injuries and their surgical outcome and management. METHODS:The authors retrospectively reviewed the cases of peroneal nerve injury associated with sports between the years 1970 and 2010. Each patient was evaluated for i...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2011.9.FOCUS11187

    authors: Cho D,Saetia K,Lee S,Kline DG,Kim DH

    更新日期:2011-11-01 00:00:00

  • Mini-open transforaminal lumbar interbody fusion.

    abstract::The potential advantages of a mini-open transforaminal interbody fusion (TLIF) operation are reduced blood loss, shorter length of stay, and less soft-tissue trauma compared to the standard open technique. Prior reports from our group and others have demonstrated successful outcomes using MIS techniques in lumbar fusi...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2013.V2.FOCUS13187

    authors: Amin BY,Tu TH,Mummaneni PV

    更新日期:2013-07-01 00:00:00

  • Endoscopic surgery for intracranial cerebrospinal fluid cyst malformations.

    abstract::Endoscopic surgery represents a new and very useful modality of treatment for intracranial cysts. The authors review the cases of 19 patients with intracranial malformative CSF cysts (seven intraventricular, six paraventricular, and six arachnoid) who underwent endoscopic fenestration by using a burr-hole approach. Th...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:

    authors: Gangemi M,Maiuri F,Colella G,Sardo L

    更新日期:1999-04-15 00:00:00

  • University of California, Los Angeles, surgical time-out process: evolution, challenges, and future perspective.

    abstract::Since the development of the WHO Safe Surgery Saves Lives initiative and Surgical Safety Checklist, numerous hospitals across the globe have adopted the use of a surgical checklist. The UCLA Health System developed its first extended Surgical Safety Checklist in 2008. Authors of the present paper describe how the time...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2012.8.FOCUS12255

    authors: McLaughlin N,Winograd D,Chung HR,Van de Wiele B,Martin NA

    更新日期:2012-11-01 00:00:00

  • Facet joint changes after application of lumbar nonfusion dynamic stabilization.

    abstract::OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patie...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.10.FOCUS15456

    authors: Lee SE,Jahng TA,Kim HJ

    更新日期:2016-01-01 00:00:00

  • Pathophysiology of adult tethered cord syndrome: review of the literature.

    abstract:OBJECT:Tethering of the spinal cord has been a recognized cause of neurological symptoms in pediatric patients and is increasingly being recognized as a cause of symptoms in adults as well. The pathophysiology surrounding spinal cord tethering has begun to be understood in the pediatric population but is still unclear ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2010.3.FOCUS1080

    authors: Stetler WR Jr,Park P,Sullivan S

    更新日期:2010-07-01 00:00:00

  • Extending statistical learning for aneurysm rupture assessment to Finnish and Japanese populations using morphology, hemodynamics, and patient characteristics.

    abstract:OBJECTIVE:Incidental aneurysms pose a challenge for physicians, who need to weigh the rupture risk against the risks associated with treatment and its complications. A statistical model could potentially support such treatment decisions. A recently developed aneurysm rupture probability model performed well in the US d...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2019.4.FOCUS19145

    authors: Detmer FJ,Hadad S,Chung BJ,Mut F,Slawski M,Juchler N,Kurtcuoglu V,Hirsch S,Bijlenga P,Uchiyama Y,Fujimura S,Yamamoto M,Murayama Y,Takao H,Koivisto T,Frösen J,Cebral JR

    更新日期:2019-07-01 00:00:00

  • Intraoperative imaging of brain tumors with fluorescein: confocal laser endomicroscopy in neurosurgery. Clinical and user experience.

    abstract:OBJECTIVE:Confocal laser endomicroscopy (CLE) is an established tool in basic research for tissue imaging at the level of microstructures. Miniaturization and refinement of the technology have made this modality available for operative imaging with a handheld device. Sufficient image contrast is provided by the preoper...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2020.11.FOCUS20783

    authors: Höhne J,Schebesch KM,Zoubaa S,Proescholdt M,Riemenschneider MJ,Schmidt NO

    更新日期:2021-01-01 00:00:00

  • The role of the mini-open thoracoscopic-assisted approach in the management of metastatic spine disease at the thoracolumbar junction.

    abstract:Objective:Treatment advances have resulted in improved survival for many cancer types, and this, in turn, has led to an increased incidence of metastatic disease, specifically to the vertebral column. Surgical decompression and stabilization prior to radiation therapy have been shown to improve functional outcomes, but...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2016.5.FOCUS16162

    authors: Ravindra VM,Brock A,Awad AW,Kalra R,Schmidt MH

    更新日期:2016-08-01 00:00:00

  • Posterior fossa arteriovenous malformations.

    abstract::Arteriovenous malformations (AVMs) of the posterior fossa are complex neurovascular lesions that are less common than their supratentorial counterparts, accounting for < 15% of all AVMs. The majority of patients with these lesions present with intracranial hemorrhage, a factor that has been consistently shown to incre...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2009.2.FOCUS0914

    authors: Arnaout OM,Gross BA,Eddleman CS,Bendok BR,Getch CC,Batjer HH

    更新日期:2009-05-01 00:00:00

  • Curative Onyx embolization of tentorial dural arteriovenous fistulas.

    abstract:OBJECT:The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. METHODS:The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization be...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2011.12.FOCUS11323

    authors: Puffer RC,Daniels DJ,Kallmes DF,Cloft HJ,Lanzino G

    更新日期:2012-05-01 00:00:00

  • Hypothalamic hamartomas. Part 1. Clinical, neuroimaging, and neurophysiological characteristics.

    abstract::Hypothalamic hamartomas are uncommon but well-recognized developmental malformations that are classically associated with gelastic seizures and other refractory seizure types. The clinical course is often progressive and, in addition to the catastrophic epileptic syndrome, patients commonly exhibit debilitating cognit...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2013.3.FOCUS1355

    authors: Mittal S,Mittal M,Montes JL,Farmer JP,Andermann F

    更新日期:2013-06-01 00:00:00

  • Predictors of outcome of subdural empyema in children.

    abstract:OBJECTIVE:The aim of this study was to report the etiology, clinical features, microbiology, surgical outcome, and predictors of outcome of spontaneous subdural empyema (SDE). METHODS:The authors conducted a retrospective study in a tertiary hospital. Children up to 18 years of age, with a diagnosis of SDE with infect...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2019.5.FOCUS19268

    authors: Konar S,Gohil D,Shukla D,Sadashiva N,Uppar A,Bhat DI,Srinivas D,Arimappamagan A,Devi BI

    更新日期:2019-08-01 00:00:00