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Classification of hypothalamic hamartoma and prognostic factors for surgical outcome
Author(s) -
Li C. D.,
Luo S. Q.,
Tang J.,
Jia G.,
Ma Z. Y.,
Zhang Y. Q.
Publication year - 2014
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12209
Subject(s) - hypothalamic hamartoma , medicine , gelastic seizure , third ventricle , hamartoma , surgery , mammillary body , hypothalamus , pathology , precocious puberty , hormone
Objectives The main aims of this study were to classify patients with hypothalamic hamartoma ( HH ) based on neuroimaging features and describe the clinical manifestations of HH . Materials and methods A retrospective review of 214 consecutive patients with HH treated in B eijing T iantan H ospital was performed. Results HH were diagnosed and divided into T ypes I–IV based on MRI . Types I and II were defined as the HH attached to the floor of the third ventricle with narrow ( T ype I) or broad ( T ype II) interfaces. Type III (‘straddling’) was defined by the HH extending into the third ventricle and interpeduncular cistern. Type IV was defined as the HH located totally within the third ventricle. The percent distribution of patients was 35.9% Type I, 12.1% T ype II, 40.7% T ype III, and 11.2% T ype IV. The percentage of patients with precocious puberty was highest in T ype I (81.8%). The percentage of patients with gelastic seizures was highest in T ype IV (91.7%). After surgery, 20% (1/5) of patients with T ype II HH , 48.8% (20/42) with Type III, and 91.7% (11/12) with Type IV were free of epileptic seizures. Significant prognostic factors for surgical outcome were HH size, surgical approach, and resection level. Conclusions The clinical manifestations of HH are correlated with the topology of the HH in relation to the hypothalamus. Our results suggest that patients with Type IV HH have the best outcome from surgery and neurosurgeons should be cautious about performing surgery on patients with T ype II and T ype III HH .