ParticipantsAna Ezponda, MD, Pamplona, Spain (Presenter) Nothing to Disclose
Marta Calvo-Imirizaldu, MD, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
Patricia Malmierca, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
Reyes M. Garcia-Eulate, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
Jose Luis Zubieta, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
Miguel Fernandez, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
Jorge Guridi, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
Pablo Dominguez Echavarri, MD, Pamplona, Spain (Abstract Co-Author) Nothing to Disclose
aezponda@unav.es
TEACHING POINTS- To review the role of MRI-Guided High Intensity Focused Ultrasound (HIFU) thalamotomy in the treatment of tremor. - To describe the role of neuroradiologists in the treatment planning and during the procedure. - To emphasize the role of pre-treatment DTI-based tractography for the precise detection of the target. - To show the precise topography of ventral intermediate nucleus (VIM) nucleus and focused-sonography lesions, based on MRI references. - To describe the imaging findings of HIFU thalamotomy side effects.
TABLE OF CONTENTS/OUTLINEA. Potential candidates for HIFU MRI-guided thalamotomy: medically refractory tremor and not candidates for surgery (Essential Tremor and Parkinson Disease). B. Treatment planning: a. Pre-treatment CT evaluation for skull score. b. Pre-treatment MRI protocol: anatomy of the cerebellothalamocortical circuit and role of diffusion tensor imaging (DTI)-based fiber tractography. c. Tips for stereotactic targeting of the VIM nucleus (based on our experience): distance to the midline and lateral wall of the third ventricle, distance to the inter-commissural plane... C. Post-treatment MRI: topography and imaging features of hyperacute focused-sonography lesions. D. Imaging findings of early complications: intracerebral hemorrage, large amount of edema, non-radial spreading of the lesioning effects.