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Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection
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Image-guided LINAC radiosurgery in hypothalamic hamartomas.

Pantaleo Romanelli1, Francesco Tuniz2, Sara Fabbro2

  • 1Cyberknife Center, Italian Diagnostic Center (CDI), Milan, Italy.

Frontiers in Neurology
|September 19, 2022
PubMed
Summary
This summary is machine-generated.

Frameless LINAC stereotactic radiosurgery (SRS) effectively treats hypothalamic hamartomas (HH) causing epilepsy. This non-invasive approach achieved seizure freedom or significant reduction in most patients without neurological complications.

Keywords:
LINACgelastic seizureshypothalamic hamartomaimage-guidancemultidrug-refractory epilepsystereotactic radiosurgery

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiation Oncology

Background:

  • Hypothalamic hamartomas (HH) are congenital malformations linked to drug-resistant epilepsy.
  • Stereotactic radiosurgery (SRS) is a minimally invasive treatment for select HH cases.
  • Frameless LINAC SRS offers a non-invasive alternative for HH treatment.

Purpose of the Study:

  • To evaluate the efficacy and safety of frameless LINAC SRS for treating hypothalamic hamartomas (HH).
  • To assess seizure control and neurological outcomes in patients with HH-related epilepsy after SRS.

Main Methods:

  • Retrospective analysis of ten patients with HH-related epilepsy treated with frameless image-guided SRS.
  • Single-fraction SRS was administered with a mean prescribed dose of 16.27 Gy.
  • Clinical and neuroradiological data were collected for outcome assessment.

Main Results:

  • Eight out of ten patients achieved Engel class I or II seizure freedom/near freedom.
  • Five patients experienced complete seizure control within 4-18 months post-treatment.
  • No neurological complications were reported in any of the treated patients.

Conclusions:

  • Frameless LINAC SRS is a safe and effective non-invasive treatment for hypothalamic hamartomas.
  • This technique provides good seizure control and long-term neuropsychosocial outcomes.
  • SRS avoids the neurological risks associated with surgical resection of HH.