颅骨密度比欠佳患者行聚焦超声丘脑切开术治疗特发性震颤的临床延迟反应——病例报告
Delayed clinical response to focused ultrasound thalamotomy in essential tremor in a patient with suboptimal skull density ratio - A case report.
作者信息
Chowdhury Elma A, Sivan Vijay, Kumar Rohit Prem, Ruzicka Iv Francis F, Azmi Hooman
机构信息
Department of Neurosurgery, Hackensack Meridian School of Medicine, Nutley, United States.
Department of Neurosurgery, Hackensack University Medical Center, Hackensack, New Jersey, United States.
出版信息
Surg Neurol Int. 2024 Nov 8;15:406. doi: 10.25259/SNI_707_2024. eCollection 2024.
BACKGROUND
Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy offers incisionless treatment for essential tremor or tremor-dominant Parkinson's disease, gaining acceptance as an alternative to deep brain stimulation. Compared to other methods, it offers real-time efficacy assessment without ionizing radiation.
CASE DESCRIPTION
A 63-year-old male underwent MRgFUS, initially yielding subtle results due to skull limitations. However, significant tremor relief emerged 6 hours post-procedure, sustained for 5 days. Imaging confirmed thalamotomy effect. A second treatment was delivered at day five for longevity.
CONCLUSION
For patients with challenging skull characteristics and initial suboptimal outcomes, staged procedures may be considered, with potential delayed benefits and the need for lesion expansion for long-term relief.
背景
磁共振成像引导聚焦超声丘脑切开术为特发性震颤或震颤为主型帕金森病提供了无创治疗方法，作为深部脑刺激的替代方法逐渐被接受。与其他方法相比，它能在不使用电离辐射的情况下进行实时疗效评估。
病例描述
一名63岁男性接受了磁共振成像引导聚焦超声丘脑切开术，由于颅骨限制，最初效果不明显。然而，术后6小时震颤明显减轻，并持续了5天。影像学检查证实了丘脑切开术的效果。在第5天进行了第二次治疗以延长疗效。
结论
对于颅骨特征具有挑战性且初始效果欠佳的患者，可考虑分阶段进行手术，可能会有延迟的益处，并且需要扩大病灶以实现长期缓解。
Zotero 插件