AI Article Synopsis
- Hypothalamic hamartomas (HH) are brain malformations linked to seizures and various hormonal and behavioral issues, typically diagnosed in childhood.
- The pedunculated and parahypothalamic types of HH can be surgically removed, showing positive outcomes for symptoms like precocious puberty, but may lead to serious complications if not approached carefully.
- The article proposes using an extradural temporopolar approach to improve surgical access to HH while minimizing risks, alongside a method for determining the safety and effectiveness of resection.
Article Abstract
Background: Hypothalamic hamartomas (HH) are malformations originating from the hypothalamus and are associated with seizures, hormonal and behavioral abnormalities.
Method: Most patients, especially those with a typical syndrome characterized by gelastic seizures, precocious puberty, cognitive decline, and behavior problems, are diagnosed in childhood. Pedunculated and parahypothalamic types of hamartomas are attached to the floor by a narrow or wide peduncle in the absence of distortion of the overlying hypothalamus. This location is most commonly associated with a clinical presentation of precocious puberty, and surgical removal has proved curative in small case series. Enthusiastic resection of hypothalamic lesions are known to produce severe hypothalamic disturbance while under resection might mean inadequate response to surgery.
Conclusions: In this article, the authors describe the use of extradural temporopolar approach to hypothalamic hamartoma as an improvisation to improve access with reduced morbidity and describe a surgical nuance of using posterior communicating artery to determine a safe but maximal resection margin.
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| http://dx.doi.org/10.1007/s00381-015-2631-8 | DOI Listing |
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