Magnetic resonance-guided focused ultrasound thalamotomy for tremor

Magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy has emerged as an effective treatment for tremor, particularly in those patients who are excluded from deep brain stimulation. The authors illustrate an example of MRgFUS thalamotomy, targeting the ventralis intermedius nucleus, in a 78-year-old patient with tremor who had features of essential tremor and tremor-predominant Parkinson's disease. Significant tremor improvement was seen during the procedure. The authors review step-by-step the preoperative considerations, Vim targeting, treatment, and outcomes for this evolving treatment modality. The video can be found here: https://stream.cadmore.media/r10.3171/2024.7.FOCVID249.