• Chao-Hung Kuo, Abdullah H Feroze, Sandra L Poliachik, Jason S Hauptman, Edward J Novotny, and Jeffrey G Ojemann.
• Department of Neurological Surgery, University of Washington, Seattle, Washington, USA; Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: chaohungk@gmail.com.
• World Neurosurg. 2019 Jan 1; 121: e191-e199.

BackgroundLaser interstitial thermal therapy (LITT) is an alternative, less-invasive, and, in some circumstances, effective treatment for patients with intracranial pathology including epilepsy and some tumors. For intracranial lesions in eloquent areas, resection by conventional craniotomy proves often to be a challenge, including in the care of pediatric patients. Herein, we reviewed our experience with magnetic resonance imaging (MRI)-guided LITT as treatment for pediatric patients with intracranial lesions in eloquent areas and evaluate neurologic function and clinical outcomes.MethodsWe retrospectively reviewed consecutive patients with intracranial lesions in eloquent speech and motor areas who underwent MRI-guided LITT. Clinical evaluation, including neurologic function and neuropsychological testing, was conducted according to clinical considerations. MRI pre- and postoperative imaging was reviewed to compare the change of lesion size.ResultsFive pediatric patients received MRI-guided LITT of intracranial lesions in eloquent cortex. One patient experienced complications secondary to MRI-guided LITT, but neither was discharged with a neurologic deficit.ConclusionsFor intracranial lesions in the eloquent cortex, conventional craniotomy with surgical resection is a challenge for neurosurgeons, especially pediatric patients. MRI-guided LITT provides a less-invasive and potentially effective option for treatment in the management of pediatric epilepsy and tumors.Copyright © 2018 Elsevier Inc. All rights reserved.

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