case_images: PMC10748471_01
case_images: Panel illustrating the different steps of the treatment of E.B.S. (A) day-30 postoperative cranial CT scan showing the burr holes at the right side after revascularization surgery (6 years-old); (B) ASL-MRI of the brain showing cortical hyperperfusion at the level of frontoparietal burr holes and on the medial part of the hemispheres; (C) Axial enhanced T1-weighted cerebral MRI at the age of 15 documenting the appearance of a posterior cingular lesion, nodular and homogeneously enhancing; (D) Axial enhanced T1-weighted cerebral MRI showing the trajectory of the LITT fiber at the end of the procedure; (E) Axial enhanced T1-weighted cerebral MRI 12 months after the surgery displaying the reduction in tumor size.
case_images: fneur-14-1291207-g002.jpg
case_images: PMC10748471_01_fneur-14-1291207-g002.jpg
case_images: fig2
case_images: He underwent left MBH surgery (Figure 2A) through a left coronal skin incision exceeding the midline, with no postoperative stroke and satisfactory revascularization of the left hemisphere on serial postoperative perfusion imaging (Figure 2B) with ASL MRI. Nine years later, follow-up MRI showed a right posterior cingular tumor suggestive of a low-grade glioma, nodular, homogeneously enhancing, and growing after 6 months (Figure 2C). Therefore, we carried out MR-guided, stereotactic, robot-assisted laser ablation surgery (Visualase, Medtronic, United States) with a right intraparietal trajectory (Figure 2D). NF1. No perioperative complications occurred, and the tumor size showed a significant reduction of 65% at 12-month follow-up (Figure 2E).