Transcranial MR-Guided Focused Ultrasound and Hyperostosis Calvariae Diffusa: Case Report and Systematic Review of the Literature

Stereotactic and Functional Neurosurgery

Bernstock J.D.a,b· Torio E.F.a· Raghu A.L.B.a,c· Chua M.Chen J.A.a· Segar D.a· Gupta S.a· White P.J.d· McDannold N.d· Golby A.J.a· Cosgrove G.R.a

Author affiliations

aDepartment of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
bDavid H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
cOxford Functional Neurosurgery, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
dDepartment of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Stereotact Funct Neurosurg 2022;100:1–9

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Article / Publication Details

First-Page Preview

Abstract of Technical Report

Received: February 14, 2022
Accepted: September 16, 2022
Published online: December 15, 2022
Issue release date:

Number of Print Pages: 9
Number of Figures: 5
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

Abstract

We describe a 74-year-old male with intractable essential tremor (ET) and hyperostosis calvariae diffusa who was unsuccessfully treated with magnetic resonance-guided focused ultrasound (MRgFUS). A computed tomography performed prior to the procedure demonstrated a skull density ratio (SDR) of 0.37 and tricortical hyperostosis calvariae diffusa. No lesion was evident on post-MRgFUS MRI, and no improvement in the patient’s hand tremor was noted clinically. We systematically reviewed the literature to understand outcomes for those patients with hyperostosis who have undergone MRgFUS. A comprehensive literature search using the PubMed, Cochrane, and Google Scholar databases identified 3 ET patients with hyperostosis who failed treatment with MRgFUS. Clinical findings, skull characteristics, treatment parameters, and outcomes were summarized, demonstrating different patterns/degrees of bicortical hyperostosis and variable SDRs (i.e., from 0.38 to ≥0.45). Although we have successfully treated patients with bicortical hyperostosis frontalis interna (n = 50), tricortical hyperostosis calvariae diffusa appears to be a contraindication for MRgFUS despite acceptable SDRs.

© 2022 S. Karger AG, Basel

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First-Page Preview

Abstract of Technical Report

Received: February 14, 2022
Accepted: September 16, 2022
Published online: December 15, 2022
Issue release date:

Number of Print Pages: 9
Number of Figures: 5
Number of Tables: 2

ISSN: 1011-6125 (Print)
eISSN: 1423-0372 (Online)

For additional information: https://www.karger.com/SFN

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