Clinical Neuroscience

[Experiences of hypothalamic hamartoma surgeries]

NOVÁK László1, KISS Máté Tamás1, KLEKNER Álmos1, NAGY Andrea2, FEDORCSÁK Imre3, BOGNÁR László1

MAY 30, 2016

Clinical Neuroscience - 2016;69(05-06)

DOI: https://doi.org/10.18071/isz.69.E032

[Background and purpose - Hypothalamic hamartomas are focal, benign congenital malformations that frequently associated with gelastic seizures. Behavioural disturbances, cognitive decline and the appearance of precocious puberty can also be observed. The most effective way to relieve the symptoms is the surgical disconnection between the hamartoma and the hypothalamus. In our study, we retrospectively analyzed the surgical indications and effectiveness of each approach. Methods - Between 1996 and 2014 we operated on 10 hypothalamic hamartomas. Endoscopic assisted resection was performed in three patients. Six patients underwent direct microsurgical resection in various approaches and one patient was treated with Gamma Knife. Results - We achieved significant decrease in the number of seizures in every patient presenting with various seizure types. The surgical resection was effective in the arresting of the puberty praecox as well. However the surgery of these lesions at their special location holds the danger of the appearance of new endocrinological symptoms. According to our observations the operation on hamartoma less effectively ameliorates the psychiatric symptoms than the others. Conclusion - The surgical treatment is effective in the reduction of the initial symptoms and we had no mortality. According to our analysis therapeutic success is anticipated but we couldn’t archive total symptomatic relief in every case. The first approach to these lesions should be the surgery which type must be tailored to each patient.]

AFFILIATIONS

  1. Debreceni Egyetem, Klinikai Központ, Idegsebészeti Klinika, Debrecen
  2. Országos Klinikai Idegtudományi Intézet, Budapest
  3. Debreceni Egyetem, Klinikai Központ, Gyermekgyógyászati Intézet, Debrecen

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