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Magnetic resonance–guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery: a case report

  • Case Report - Functional Neurosurgery - Epilepsy
  • Published:
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Abstract

We report the case of a patient with hypothalamic hamartoma (HH) who was successfully treated with magnetic resonance–guided focused ultrasound (MRgFUS) for ablation as a disconnection surgery. A 26-year-old man with gelastic epilepsy had been diagnosed with HH at 3 years of age, and antiepileptic drugs were administered due to worsening episodes. Magnetic resonance imaging showed a sessile parahypothalamic hamartoma and MRgFUS ablation was performed, creating an oval-shaped lesion at the boundary area of the HH. Dramatic improvements in seizure symptoms were noted, and he was seizure-free on decreased antiepileptic drugs without any adverse events over the 1-year follow-up period.

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Abbreviations

AC:

Anterior commissure

CBZ:

Carbamazepine

DTI:

Diffusion tensor imaging

DTT:

Diffusion tensor tractography

EEG:

Electroencephalogram

FA:

Fractional anisotropy

FDG-PET:

Fludeoxyglucose positron emission tomography

HH:

Hypothalamic hamartoma

MRgFUS:

Magnetic resonance-guided focused ultrasound

MR:

Magnetic resonance

PC:

Posterior commissure

STIR:

Short TI inversion recovery

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Acknowledgments

We thank Itay Rachmilevitch and Dr. Haris Sair for their invaluable assistance and editing in the conduct of this study. We also acknowledge Dr. Ichiro Takumi for referring the patient to our hospital.

Author information

Authors and Affiliations

  1. Research Institute of Diagnostic Radiology, Shin-Yurigaoka General Hospital, 255 Furusawa-tsuko Asaoku, Kawasaki, Kanagawa, 215-0026, Japan

    Toshio Yamaguchi

  2. Department of Neurosurgery, Moriyama Neurological Center Hospital, Tokyo, Japan

    Tomokatu Hori

  3. Department of Radiology, Shin-Yurigaoka General Hospital, Kanagawa, Japan

    Hiroki Hori

  4. Department of Anesthesiology, Shin-Yurigaoka General Hospital, Kanagawa, Japan

    Masahito Takasaki

  5. Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo, Japan

    Keiichi Abe & Takaomi Taira

  6. Neuroimaging Research, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

    Kenji Ishii

  7. Southern Tohoku Research Institute for Neuroscience, Fukushima, Japan

    Kazuo Watanabe

Authors
  1. Toshio Yamaguchi
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  2. Tomokatu Hori
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  3. Hiroki Hori
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  4. Masahito Takasaki
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  5. Keiichi Abe
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  6. Takaomi Taira
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  7. Kenji Ishii
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  8. Kazuo Watanabe
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Toshio Yamaguchi, Tomokatu Hori, Hiroki Hori, Masahito Takasaki, Keiichi Abe, Takaomi Taira, Kenji Ishii, and Kazuo Watanabe. The first draft of the manuscript was written by Toshio Yamaguchi, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Toshio Yamaguchi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The patient has consented to the submission of the case report for submission to the journal.

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This article is part of the Topical Collection on Functional Neurosurgery - Epilepsy

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Yamaguchi, T., Hori, T., Hori, H. et al. Magnetic resonance–guided focused ultrasound ablation of hypothalamic hamartoma as a disconnection surgery: a case report. Acta Neurochir 162, 2513–2517 (2020). https://doi.org/10.1007/s00701-020-04468-6

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  • DOI: https://doi.org/10.1007/s00701-020-04468-6

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