Abstract
Laser interstitial thermal therapy has become increasingly popular for targeting epileptic foci in a minimally invasive fashion. Despite its use in >1000 patients, the long-term effects of photothermal injury on brain physiology remain poorly understood. We prospectively followed clinical and radiographic courses of 13 patients undergoing laser ablation for focal epilepsy by the senior author (N.T.). Only patients with nonenhancing lesions and patients who had a delayed postoperative magnetic resonance imaging (MRI) scan with gadolinium administration approximately 6 months after ablation were considered. Volumetric estimates of the amount of enhancement immediately after ablation and on the delayed MRI scan were made. Median interval between surgery and delayed postoperative MRI scan was 6 months (range, 5-8 months). In 12 of 13 cases, persistent enhancement was seen, consistent with prolonged blood-brain barrier dysfunction. Enhancement, when present, was 9%-67% (mean 30%). There was no correlation between the time from surgery and the relative percentage of postoperative enhancement on MRI. The blood-brain barrier remained compromised to gadolinium contrast for up to 8 months after thermal therapy. There were no adverse even...Continue Reading
References
Apr 1, 1983·Proceedings of the National Academy of Sciences of the United States of America·R S FujinamiH Koprowski
Sep 17, 1998·Epilepsia·H LüdersE Wyllie
Jul 16, 2004·Acta neurochirurgica·P C SchulzeR Schober
Feb 27, 2007·Epilepsia·Nicola MarchiDamir Janigro
May 30, 2007·Brain : a Journal of Neurology·Valérie RigauMireille Lerner-Natoli
Jul 6, 2010·Brain Research·Nicola MarchiDamir Janigro
Oct 19, 2011·Biomarkers in Medicine·Annamaria Vezzani, Alon Friedman
Mar 1, 2012·Epilepsia·Anna RaabePitt Niehusmann
Apr 24, 2012·Neuropharmacology·Annamaria VezzaniRaymond J Dingledine
Jul 4, 2012·Brain : a Journal of Neurology·Joan Y W LiuSanjay M Sisodiya
Apr 9, 2013·Journal of Neurosurgery·Andrew E SloanGene H Barnett
Apr 17, 2013·Epilepsia·Imad NajmWilliam Bingaman
Feb 13, 2014·Epilepsy Research·Yoshua EsquenaziNitin Tandon
May 9, 2014·Cancer Medicine·Alireza M MohammadiEric C Leuthardt
Oct 14, 2014·Advances in Pharmacology·Nancy D DoolittleEdward A Neuwelt
Dec 10, 2014·Epilepsia·Daniel L DraneRobert E Gross
Dec 17, 2014·PloS One·Pallavi TiwariAnant Madabhushi
Feb 19, 2015·Current Opinion in Neurology·Robert E GrossJonathan P Riley
Mar 3, 2015·Neurosurgical Focus·Symeon MissiosGene H Barnett
Jun 19, 2015·Neurosurgery·Xiaonan R SunShabbar F Danish
Jun 27, 2015·AJNR. American Journal of Neuroradiology·R MedvidM B Desai
Feb 26, 2016·PloS One·Eric C LeuthardtDavid D Tran
Citations
Jun 13, 2018·Epilepsia·Cristian DonosNitin Tandon
Dec 7, 2017·Epilepsia·Suganya KarunakaranNitin Tandon
Feb 28, 2020·Neurology·Cristian DonosNitin Tandon
Jul 17, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Madison RemickTaylor J Abel
Jul 17, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Ethan S SrinivasanPeter E Fecci
Jul 17, 2020·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Joshua D FrensterDimitris G Placantonakis
Apr 7, 2020·World Neurosurgery·Mayur SharmaBrian J Williams
Dec 18, 2020·Frontiers in Neurology·Kunal GuptaJon T Willie
Oct 31, 2020·Current Neurology and Neuroscience Reports·Hui Ming KhooFrançois Dubeau
May 8, 2021·Clinical Neurology and Neurosurgery·Alexandros G BrotisKonstantinos N Fountas
Jul 30, 2021·Journal of Neurology, Neurosurgery, and Psychiatry·Niravkumar BarotAnto Bagic
Oct 31, 2021·Journal of Neurology, Neurosurgery, and Psychiatry·David SatzerPeter Warnke