{"id":"2ccf6a17-8429-40a9-b810-e511dfcd428c","slug":"delayed-clinical-response-to-focused-ultrasound-thalamotomy-in-essential-tremor-in-a-patient-with-suboptimal-skull-density-ratio-a-case-report","title":"Delayed clinical response to focused ultrasound thalamotomy in essential tremor in a patient with suboptimal skull density ratio – A case report","authors":["Elma A. Chowdhury","Vijay Sivan","Rohit Prem Kumar","Francis F. Ruzicka IV","Hooman Azmi"],"abstract":"Background: Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy offers incisionless treatment for essential tremor or tremor-dominant Parkinson’s disease, gaining acceptance as an alternative to deep brain stimulation. Compared to other methods, it offers real-time efficacy assessment without ionizing radiation. Case Description: A 63-year-old male underwent MRgFUS, initially yielding subtle results due to skull limitations. However, significant tremor relief emerged 6 hours post-procedure, sustained for 5 days. Imaging confirmed thalamotomy effect. A second treatment was delivered at day five for longevity. Conclusion: For patients with challenging skull characteristics and initial suboptimal outcomes, staged procedures may be considered, with potential delayed benefits and the need for lesion expansion for long-term relief.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/2ccf6a17-8429-40a9-b810-e511dfcd428c/featured/hero-1781559096668.png","publishDate":"2024-11-08T00:00:00.000Z","doi":"10.25259/SNI_707_2024","categories":["Unique Case Observations","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/2ccf6a17-8429-40a9-b810-e511dfcd428c/pdf"}