Frame-Based Stereotactic Surgery in Thalamic Lesions

Abstract

Background: Stereotactic surgery is recommended over dramatic excision for the management of thalamic malignancies because the thalamus is a vital structure surrounded by essential white matter pathways. Aim of the work: Assessment of the benefits and safety of the framebased stereotactic surgery in thalamic lesions. Patients and Methods: Retrospective study conducted on 15 patients suffering from different thalamic lesions, recruited from Neurosurgery Department, Al-Azhar University and Ministry of Health Hospitals over the period from 2016 to 2021.Result: Patients mean age were 39.53 ± 15.58 years old. 40% of them were males and 60% were females. Majority (81.8%) of patients presenting with headache preoperatively had improved postoperatively, no statistically significant difference. patients with Dysphasia, 44.4% improved as a result of the operation. Regarding patients presenting with symptoms of increased intracranial pressure; the 3 patients who presented with repeated vomiting had improved. For consciousness level, 50% of patients presenting with DCL had improved. Patients presenting with bilateral hyperreflexia, showing clinical improvement in 100% of patients. Pneumocephalus was the most common complications met, which was prevalent in 66.7% of patients followed by intralesional hematoma which performed 20% of the population. Obstructive hydrocephalus came into the least order. Conclusion: Thalamic lesions treated by frame-based stereotactic surgery showed postoperative improvement of headache, symptoms of increased intracranial pressure, and bilateral hyper-reflexia with no statistically significant difference between pre. and post-operative symptoms, on the other side no improvement were documented regarding unilateral hyperreflexia, Right and left hemiparesis, ataxia and vision.