Stereotactic and Functional Neurosurgery最新文献

{"title":"Primary Gamma Knife Radiosurgery for Trigeminal Schwannoma: A Retrospective Analysis of Long-Term Functional Outcomes.","authors":"Kyung Won Chang, Won Jae Lee, Kyuha Chong, Jung-Won Choi, Doo-Sik Kong, Ho Jun Seol, Do-Hyun Nam, Jung-Il Lee","doi":"10.1159/000549089","DOIUrl":"10.1159/000549089","url":null,"abstract":"<p><p><p>Introduction: Trigeminal schwannomas (TSs) are rare benign tumors arising from the trigeminal nerve. Gamma Knife radiosurgery (GKS) offers a minimally invasive alternative to surgical resection, but the long-term clinical outcomes, particularly regarding change of trigeminal nerve function, remain under-characterized. This study aimed to evaluate long-term clinical outcomes and identify prognostic factors for neurological sequelae following primary GKS for TS.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 89 patients who underwent primary GKS for TS between 2002 and 2023. Patients with prior surgery or hypofractionation were excluded. Clinical and imaging data were analyzed for tumor control, symptom relief, and new-onset, or persistent post-GKS morbidities. Symptoms were classified as new-onset transient, new-onset permanent, or persistent preexisting. The Kaplan-Meier analysis, Logistic regression, and Cox regression were used to identify prognostic factors.</p><p><strong>Results: </strong>Over a median follow-up of 57 months (range, 6.8-184), tumor control was 93.3%. Symptom relief occurred in 46.9% of preexisting deficits, highest for headache (70.6%) and dizziness (100%), but modest for trigeminal pain (33.3%) and paresthesia (36.7%). New-onset morbidities included trigeminal sensory disturbance (33.7%, permanent in 15) and pain (22.5%, permanent in 5). In Cox analysis, higher margin dose reduced the hazard of new paresthesia (HR 0.511, p = 0.036), while older age increased risk (HR 1.041, p = 0.037).</p><p><strong>Conclusion: </strong>Primary GKS achieves durable tumor control for TS with lower risk than microsurgery. However, a considerable proportion of patients may experience long-term trigeminal dysfunction. Adequate dosing may mitigate sensory morbidity, though pain relief remains modest. Careful selection, counseling, and follow-up are essential. </p>.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"71-80"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Factors Contribute to Heterogeneous Motor Outcomes in Parkinson's Disease after Subthalamic Deep Brain Stimulation.","authors":"Ruoyu Ma, Shu Wang, Tianshuo Yuan, Zixiao Yin, Guanyu Zhu, Tingting Du, Yingchuan Chen, Jianguo Zhang","doi":"10.1159/000549254","DOIUrl":"10.1159/000549254","url":null,"abstract":"<p><strong>Introduction: </strong>Subthalamic deep brain stimulation (STN-DBS) is an established treatment for Parkinson's disease (PD); however, long-term motor outcomes vary, affecting patients' quality of life. Identifying the factors that influence these heterogeneous motor outcomes is essential. This study investigated the factors influencing heterogeneous motor outcomes in patients with PD after STN-DBS and developed predictive models using preoperative demographic and clinical factors.</p><p><strong>Methods: </strong>We studied 92 patients with PD who underwent bilateral STN-DBS at the Beijing Tiantan Hospital between 2020 and 2022. Motor outcomes were assessed preoperatively and 1 and 12 months postoperatively. Patients were grouped based on different motor outcomes (change in Unified Parkinson's Disease Rating Scale Part III scores) between the 12- and 1-month assessments: those achieving minimal clinically significant motor improvement (MCID+) and those who did not (MCID-). Machine-learning models were used to predict outcomes based on preoperative factors.</p><p><strong>Results: </strong>The MCID+ group (n = 46) showed significantly better motor outcomes at the 1-year follow-up than the MCID- group (n = 46, mean difference 10.47, p < 0.001). A lower levodopa equivalent daily dose (p < 0.01), reduced anxiety (p < 0.05), reduced depression (p < 0.001), and milder freezing of gait (p < 0.05) were associated with better motor outcomes. Predictive models using logistic regression and XGBoost achieved a high accuracy (82%) in forecasting motor outcomes.</p><p><strong>Conclusions: </strong>Preoperative non-motor factors, particularly emotional status, significantly affected motor outcomes following STN-DBS. Machine-learning models enhance prognostic accuracy and offer the potential for personalized treatment strategies.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"242-255"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subthalamic versus Posterior Subthalamic Stimulation for Optimal Tremor Control in Parkinson's Disease.","authors":"Gabriele Bellini, Vincenzo Daniele Boccia, Roberto Ceravolo, Alon Mogilner, Michael H Pourfar","doi":"10.1159/000549916","DOIUrl":"10.1159/000549916","url":null,"abstract":"<p><p><p>Introduction: Tremor-predominant Parkinson's disease (TPPD) generally responds favorably to deep brain stimulation (DBS) targeting the subthalamic nucleus (STN). However, traditional stereotactic targeting of the STN does not universally yield the anticipated intraoperative improvement, prompting exploration of additional targets to achieve optimal results prior to permanent implantation of electrodes. The posterior subthalamic area (PSA), including the caudal zona incerta (cZI), have been associated with tremor suppression and can be easily compared to the neighboring STN intraoperatively.</p><p><strong>Methods: </strong>We retrospectively compared intraoperative and clinical outcomes in tremor-dominant PD patients who prospectively underwent dual trajectory microelectrode monitor targeting the STN and PSA/cZI. We compared the neurophysiology and tremor response of both the central (STN) and posterior (PSA) trajectories in 22 patients and analyzed outcomes in those who ultimately received traditional STN (16) or PSA/cZI lead implantation (12).</p><p><strong>Results: </strong>While both groups achieved substantial overall motor improvement under chronic stimulation, intraoperative test stimulation through the posterior path produced more consistent tremor arrest compared with STN. These findings suggest that positioning the DBS lead further posteriorly to engage the PSA can augment tremor suppression in select cases of TPPD without compromising other parkinsonian symptom relief.</p><p><strong>Conclusion: </strong>Our results emphasize the value of intraoperative physiological feedback in trajectory selection in tremor-predominant patients and are consistent with emerging literature that PSA/cZI DBS is an effective and potentially superior target for management of tremor in PD. </p>.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"213-224"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asleep Deep Brain Stimulation for Essential Tremor.","authors":"Tessa A Harland, Shruti Gupta, Matthew Hefner, Jessica Wilden","doi":"10.1159/000548475","DOIUrl":"10.1159/000548475","url":null,"abstract":"<p><strong>Introduction: </strong>Deep brain stimulation (DBS) was approved for essential tremor by the Food and Drug Administration (FDA) in 1997. Since that time, technological advancements in implanted hardware and operative technique have changed the landscape of functional neurosurgery. Interventional MRI-guided DBS lead placement is an emerging technique that can be used to treat ET patients, though the data are limited due to the perceived difficulty of direct targeting the ventral intermediate nucleus (VIM) relative to other structures. Here we review the experience of a single surgeon with interventional MRI-guided DBS targeting of the VIM in ET patients under general anesthesia in a community setting.</p><p><strong>Method: </strong>We conducted a retrospective chart review of ET patients who underwent DBS under general anesthesia using an MRI-guided ClearPoint surgical technique at Willis-Knighton Health System between 2016 and 2021. Demographics, radial error, procedure details, complications, and clinical outcomes were collected. Clinical outcome measures included postoperative medication reduction, the Quality of Life in Essential Tremor Questionnaire (QUEST), and a reduced 19-item version of the Fahn-Tolosa-Marín (FTM) tremor rating scale (upper-limb items from parts A-C; maximum 76 points).</p><p><strong>Results: </strong>A total of 113 ET patients (50 females [44.2%]; mean age 68.1 ± 9.4) underwent placement of 175 DBS leads. The 2D radial error was 0.43 ± 0.33 mm with only 2 leads requiring more than one pass. Following DBS placement, 69.2% stopped or reduced medication. On the reduced 19-item FTM (maximum 76 points), scores improved from 34.0 preoperatively to 8.9 postoperatively (-76.4%, p < 0.001). The QUEST Summary Index improved from 47.1 preoperatively to 29.4 postoperatively with an average improvement of 77.8%.</p><p><strong>Conclusion: </strong>Interventional MRI-guided DBS lead placement under general anesthesia is a feasible and effective technique for ET patients that may expand the reach of DBS therapy to those with significant anxiety regarding traditional, awake surgery.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"42-54"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Pain Relief after Index Gamma Knife Radiosurgery for Trigeminal Neuralgia: Retrospective Analysis of a 25-Year Series.","authors":"Venkatesh Shankar Madhugiri, Victor Goulenko, Neil D Almeida, Shefalika Prasad, Charlotte Ivey Rivers, Rohil Shekher, Andrew J Fabiano, Robert J Plunkett, Lindsay Lipinski, Kenneth V Snyder, Elad I Levy, Matthew B Podgorsak, Robert A Fenstermaker, Dheerendra Prasad","doi":"10.1159/000549634","DOIUrl":"10.1159/000549634","url":null,"abstract":"<p><strong>Introduction: </strong>Gamma Knife radiosurgery (GKRS) is an established treatment for trigeminal neuralgia; however, predictors of pain relief following treatment remain unclear. We aimed to identify the factors associated with pain relief after the index GKRS session for trigeminal neuralgia.</p><p><strong>Methods: </strong>We retrospectively analyzed a series of 204 patients with trigeminal neuralgia treated with GKRS between 1998 and 2023 (mean age 65.2 years, 68.5% female). Patient variables (pretreatment Roswell Park and Barrow Neurological Institute [BNI] pain scores, symptom duration, prior therapies, multiple sclerosis (MS) status), MRI metrics (neurovascular contact and trigeminal nerve dimensions), and radiosurgery parameters (isocenter location and radiation dose, including biologically effective dose [BED]) were assessed. Responders were defined as BNI <IIIb or RPS <3.</p><p><strong>Results: </strong>At last follow-up (median 20 months, range 6 months to 26 years), 57.3% of patients achieved pain relief. At ≥3-year follow-up, 74.1% of patients maintained adequate pain relief. MS and prior interventions were associated with lower response rates: MS patients had 27.7% response vs. 57.7% without MS (p = 0.008), and prior microvascular decompression (MVD) had 34.4% vs. 62.7% without prior MVD (p = 0.005). GKRS as first-line therapy yielded better outcomes than when used after other treatments (63.9% vs. 38.9%, p = 0.045). Responders had a smaller trigeminal nerve (mean diameter 3.04 vs. 3.42 mm, p = 0.007) and a greater isocenter-to-brainstem orthogonal distance (4.2 vs. 3.5 mm, p = 0.02). A BED ≥2000 Gy was associated with higher response rate (75.8% vs. 48.8%, p = 0.006). In multivariate analysis, absence of MS, no prior MVD, smaller nerve diameter, and BED ≥2000 Gy independently predicted pain relief.</p><p><strong>Conclusion: </strong>Non-modifiable factors that affected response included absence of MS and smaller trigeminal nerve size. Modifiable factors that were associated with higher response rates included no prior MVD, placing the isocenter farther from the brainstem surface, and BED ≥2000 Gy. These findings support individualized treatment sequencing and GKRS planning to optimize outcomes of GKRS for trigeminal neuralgia.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"182-193"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Unilateral Deep Brain Stimulation for Gait Enhancement in Parkinson's Disease: A Systematic Review and Meta-Analysis.","authors":"Ahmad Soltani, Seyed Reza Abdipour Mehrian, Vahid Reza Ostovan, Peyman Petramfar, Saba Nouri, Maryam Adel, Ali Namjoo-Moghadam","doi":"10.1159/000548468","DOIUrl":"10.1159/000548468","url":null,"abstract":"<p><strong>Introduction: </strong>Bilateral electrode implantation is the primary approach for deep brain stimulation (DBS) in Parkinson's disease (PD). However, it may lead to gait deterioration in some patients. This study aimed to investigate the efficacy of unilateral DBS on gait in PD patients as an alternative with fewer side effects and lower costs.</p><p><strong>Methods: </strong>We systematically searched four major clinical databases to evaluate the effects of unilateral DBS on UPDRS gait score, gait velocity, stride length, cadence, and gait initiation in PD patients. Twenty-three studies were included in the review, selected from an initial pool of 2,415 studies. We also performed a meta-analysis to assess the impact of unilateral DBS on gait velocity and compare its efficacy to bilateral stimulation. The study protocol was registered at PROSPERO with the registration code: CRD42024585359.</p><p><strong>Results: </strong>The included studies assessed gait measures in patients receiving unilateral DBS targeting the STN, globus pallidus internus, pedunculopontine nucleus, and ventral intermediate nucleus. According to the systematic review of clinical evidence, unilateral DBS can improve the UPDRS gait score, freezing of gait, and gait velocity, although to a lesser extent than bilateral stimulation. The meta-analysis revealed a nonsignificant positive pooled effect on gait velocity in the unilateral DBS condition compared to the control condition and no significant difference when compared to bilateral DBS.</p><p><strong>Conclusion: </strong>Unilateral DBS shows promise for improving gait in PD, as an alternative with lower costs and side effects, especially in early-stage or asymmetric cases.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"135-146"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Lesioning for Hemidystonia: A Systematic Review and Meta-Analysis with Individual Patient Data.","authors":"Arif Abdulbaki, Amr Jijakli, Ali Savas, Angelo Rafael Cunha de Azevedo, Erich Talamoni Fonoff, Paresh K Doshi, Joachim K Krauss","doi":"10.1159/000548654","DOIUrl":"10.1159/000548654","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency lesioning (RL) had been a mainstay in functional neurosurgery for dystonic movement disorders before the widespread adoption of deep brain stimulation. Outcomes of RL in hemidystonia have varied. This review provides a systematic analysis of RL for hemidystonia and evaluates the spectrum of clinical outcome.</p><p><strong>Methods: </strong>A systematic literature review was performed according to PRISMA guidelines in PubMed, Embase, and Web of Science using customized software (UiPath, NY) to identify all cohort studies, case series, and case reports on patients with hemidystonia treated with RF. Manuscripts were automatically searched for the term \"hemidystonia.\" The selected manuscripts were then manually screened. Detailed information from two recent multi-patient studies was added. Outcome was assessed according to changes in rating scales or by the reported clinical descriptions. Clinical improvement then was classified as follows: (0) no improvement, (I) mild, (II) moderate, (III) marked improvement.</p><p><strong>Results: </strong>Twenty-eight studies with individual patient data were included, totaling 101 cases published between 1962 and 2024. Thalamotomy/subthalamic region lesioning was performed in 80 cases, pallidotomy in 16, and both in 5. At the last follow-up, the overall distribution of clinical improvement was statistically significant (p = 0.0004) where the majority of patients (44.09%) showed moderate improvement. No significant differences were found between targets or etiologies, though patients with traumatic brain injury tended to fare worse. A significant negative linear correlation was found between the degree of improvement and age at surgery.</p><p><strong>Conclusion: </strong>With advancements in targeting and technology, RL may represent a viable treatment option for selected patients with hemidystonia. However, given the current evidence limitations, prospective studies with standardized outcome assessments are needed to better characterize response variability and identify prognostic factors.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"108-124"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Robots in Epilepsy Surgery.","authors":"Matthias Tomschik, Christian Dorfer","doi":"10.1159/000548427","DOIUrl":"10.1159/000548427","url":null,"abstract":"","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"65"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering the Role of Sequelae in Posterior Callosotomy.","authors":"William Alves Martins, Eliseu Paglioli, Thomas More Frigeri, Rafael Paglioli, Eduardo Leal-Conceição, Vicenzo Zarpellon, Fernanda Schuh Martins, André Palmini","doi":"10.1159/000549722","DOIUrl":"10.1159/000549722","url":null,"abstract":"","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"152-154"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Changes and Clinical Outcome after MR-Guided Laser Interstitial Thermal Therapy.","authors":"Lottem Bergman, Ariel Agur, Segev Gabay, Ariel Tankus, Itai Strauss, Leor Zach, Orna Aizenstein, Rachel Grossman, Tal Shahar, Ido Strauss","doi":"10.1159/000549229","DOIUrl":"10.1159/000549229","url":null,"abstract":"<p><p><p>Introduction: MR-guided laser interstitial thermal therapy (MRgLITT) is a minimally invasive technique for treating deep-seated brain lesions. However, the dynamics of imaging changes that occur after the ablation are not well characterized. This study aimed to describe the clinical outcomes and volume changes that occur over time after MRgLITT.</p><p><strong>Methods: </strong>We retrospectively collected clinical and imaging data of all adult patients who underwent MRgLITT of brain tumors (primary and metastatic) between 01/2020 and 06/2024. Volumes and diameters of the lesions were measured on gadolinium-enhanced T1-weighted images using Brainlab Elements. Local control was assessed at the last follow-up.</p><p><strong>Results: </strong>Twenty-nine patients with 32 treated lesions were available for assessment. Most lesions (n = 21) were metastatic, while 11 lesions were gliomas. The mean follow-up period was 23.4 ± 13.1 months. The average preoperative tumor volume was 2.8 ± 1.8cc. Post-ablation, the lesions' volumes increased on average by 250% (up to 450%) in the first month after surgery compared to the preoperative volumes. The enhancing ring extended distally beyond the tip of the catheter for an average of 4.5 ± 1.8 mm. Glial lesions had a median progression-free survival of 8.5 months. The volume of metastatic lesions decreased below the preoperative volume on average 3 months after surgery. Local control was achieved in 16 of 21 metastatic lesions (76%) and was significantly better for lesions smaller than 4cc in volume and 16 mm in maximal diameter that could be completely covered by the thermal damage estimation. Nodular enhancement at 3 months post-surgery was correlated with local failure.</p><p><strong>Conclusion: </strong>MRgLITT can achieve good local control in metastatic brain lesions and should be considered early during follow-up after radiosurgery when local failure is suspected. The enhancing lesion extends beyond the tip of the catheter and enlarges during the first month post-ablation before gradually decreasing in size. Failure to decrease in size after 3 months or appearance of a nodular enhancement should raise suspicion of local failure. </p>.</p>","PeriodicalId":22078,"journal":{"name":"Stereotactic and Functional Neurosurgery","volume":" ","pages":"166-181"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}