{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:54:35Z","timestamp":1786125275893,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Magnetic resonance imaging\u2013guided focused ultrasound (MRgFUS) thalamotomy is a rapidly evolving therapy for the treatment of essential tremor. Although the skull is a major determinant of the delivery of acoustic energy to the target, how the presence of a prior craniotomy must be accounted for during lesioning is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To demonstrate novel application of this therapeutic option in a patient with a history of prior craniotomies for unrelated intracranial pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A 55-yr-old man with a history of right frontal craniotomy for resection of a colloid cyst underwent a left ventrointermedius nucleus thalamotomy through MRgFUS. The prior craniotomy flap was not excluded in the treatment plan; however, all bony defects and hardware were marked as \u201cno-pass\u201d regions. Clinical outcomes were collected at the 6-mo follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Transducer elements whose acoustic paths would have been altered by the craniotomy defect were turned off. Sonications reaching lesional temperatures of up to 56\u00b0C were successfully delivered. The procedure was well-tolerated, without any persistent intra-ablation or postablation adverse effects. The presence of a lesion was confirmed on MRI, which was associated with a significant reduction in the patient's tremor that was sustained at the 6-mo follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>This case demonstrates the safety and efficacy of MRgFUS thalamotomy in a patient with prior craniotomies and highlights our strategy for acoustic lesioning in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1227\/ons.0000000000000012","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T13:47:27Z","timestamp":1640180847000},"page":"61-65","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Feasibility of Magnetic Resonance\u2013Guided Focused Ultrasound Thalamotomy for Essential Tremor in the Setting of Prior Craniotomy"],"prefix":"10.1227","volume":"22","author":[{"given":"Connor","family":"Wathen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew I.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick L.","family":"Hitti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenora","family":"Henry","sequence":"additional","affiliation":[{"name":"InSightec Inc, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanane","family":"Chaibainou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon H.","family":"Baltuch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"issue":"8","key":"R1-20250821","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1056\/NEJMoa1600159","article-title":"A randomized trial of focused ultrasound thalamotomy for essential tremor","volume":"375","author":"Elias","year":"2016","journal-title":"N Engl J 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