Robert E. Gross1, 2, Amit Saindane, 23, Hiroumi D. Kitajima, 23, Bobbie Burrow, 24, Ashok Gowda5, Sherif G. Nour, 23
1Neurosurgery, Emory University School of Medicine , Atlanta, GA, United States; 2Emory Interventional MRI Program, Emory University Hospital , Atlanta, GA, United States; 3Radiology and Imaging Sciences, Emory University School of Medicine , Atlanta, GA, United States; 4Radiology and Imaging Sciences, Emory University Hospital , Atlanta, GA, United States; 5Visualase, Inc., Houston, TX, United States
Patients with refractory mesial temporal lobe epilepsy are candidates for surgical mesial temporal lobe resection. There is a growing trend toward more selective resections of the amygdala/hippocampus to improve cognitive outcomes. However, "selective amygdalo-hippocampectomy may still be complicated by collateral damage en-route to mesial temporal lobe structures. This report introduces a minimally invasive alternative via percutaneous selective laser hippocampectomy where laser fiber insertion in the hippocampus is confirmed/adjusted under MRI and followed by temperature-controlled targeted energy deposition under real-time MRI monitoring within a dedicated interventional MRI suite. Technical aspects, feasibility, safety, and MRI appearance of resultant ablation zones are described.
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