Syracuse, NY | September 2013
Upstate is one of the few centers in the world that offers this minimally invasive neurosurgical treatment. Zulma Tovar-Spinoza, MD is pictured in the operating room with a pediatric patient recently.
DEEP BRAIN TUMORS, EPILEPSY NOW TREATED WITH MRI-GUIDED LASER ediatric neurosurgeon Zulma TovarSpinoza, MD, uses a laser — guided in real time by magnetic resonance imaging — to offer a minimally invasive treatment option for children with deep brain tumors or epilepsy.
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“Upstate is one of the pioneers and one of the few centers in the world that is using this technique for patients with brain tumors and epilepsy,” said Tovar-Spinoza, director of pediatric neurosurgery at the Upstate Golisano Children’s Hospital. The goal is to gain control of seizures by removing or disconnecting a lesion. This procedure is used for a variety of epileptogenic focuses, including hypothalamic hamartomas, cortical dysplasias, cortical malformations and tubers. In patients with deep-seated lesions that are challenging surgically, this option is proving to be absolutely safe with excellent results. Patients wear a frame on their heads so that precise measurements can be taken before they are wheeled to the MRI suite for thermal ablation.
Instead of a craniotomy, Tovar-Spinoza introduces a small diameter fiber optic applicator into the lesion through a 3-millimeter keyhole stereotactic procedure. The ablation procedure is supervised by real-time mapping and confirmed by immediate post-ablation MRI images. “The beauty of this technology is that you can actually see on the monitor the change of colors and temperature of the area that you are ablating,” she explained. “It’s so precise. You know that are you preserving areas of the brain where you want to preserve function.” Tovar-Spinoza and colleague, Yaman Eksioglu, MD, PhD, director of pediatric neurology, have designed a pioneer multistaged treatment for patients with tuberosclerosis and epilepsy. “We are the only center in the world performing this treatment,” she said. Patients typically are discharged from the hospital the next day. ■
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