Abstract
Hypothalamic hamartoma (HH) is a congenital intracranial lesion associated with precocious
puberty and gelastic epilepsy in children. Surgical management of HH to treat refractory
epilepsy is a mainstay of treatment. Our aim was to compare the demographic characteristics
and perioperative costs associated with resection by craniotomy and stereotactic laser
ablation (SLA) by reviewing our institutional experience with SLA and comparing these
data to a national database for craniotomy and resection. Retrospective chart review
was conducted for the Texas Children's Hospital cohort of patients who underwent SLA
for HH between 2011 and 2013. Information about the craniotomy cohort representing
historical cases of craniotomy was obtained from the Kids' Inpatient Database for
years 2003, 2006, and 2009. The cohort definition for patients undergoing craniotomy
for HH was modified from published adult literature to identify pediatric patients
with refractory epilepsy secondary to HH. Our study has shown that children undergoing
SLA for HH have a shorter length of stay and lower cost of hospitalization compared
with those who underwent craniotomy and resection for the same diagnosis. Together
with previous findings from our institution regarding the safety and efficacy of SLA,
our findings suggest that SLA may represent an attractive alternative to craniotomy
for the treatment of refractory epilepsy secondary to HH.
Keywords
hypothalamic hamartoma - laser ablation - stereotactic ablation - epilepsy - cost
- hospitalization charges - gelastic seizures
