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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

Stereotactic radiosurgery for hypothalamic hamartomas

Stereotaktische Radiochirurgie bei Hypothalamushamartomen

Meeting Abstract

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  • corresponding author F. Unger - Universitätsklinik für Neurochirurgie, Medizinische Universität Graz
  • B. Unger - Universitätsklinik für Radiologie, Medizinische Universität Graz
  • M. Feichtinger - Universitätsklinik für Neurologie, Medizinische Universität Graz

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 032

The electronic version of this article is the complete one and can be found online at:

Published: May 30, 2008

© 2008 Unger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Hypothalamic hamartomas are non-neoplastic lesions often characterized by central precocious puberty and gelastic epilepsy. Due to the delicate location surgery is often unsuccessful and associated with considerable risks. In the presented series, Gamma Knife radiosurgery was applied. Low doses of radiosurgery (10–20 Gy) have proved effective for the suppression of epileptogenic activity and minimize the risk of complication.

Methods: Six cases (aged between 5–18 years) who presented with medically intractable gelastic epilepsy and increasing secondary generalization, abnormal behaviour and precocious puberty (3 cases) are reported. Hypothalamic hamartomas sized 11–17 mm had been diagnosed by MR imaging. Radiosurgical treatment was performed in general anaesthesia with margin doses of 12–14 Gy to the 50–90% isodoses covering volumes of 600–2300 mm3.

Results: After follow-up periods of 24 to 78 months, a continuing decrease both in seizure frequency and intensity was noted (outcome according to Engel II a (5 cases) and III a (1 case)). All patients are socially reintegrated. MR imaging did not reveal significant changes concerning the size of the lesions.

Conclusions: Gamma Knife radiosurgery can be an effective and safe alternative treatment modality for hypothalamic hamartomas capable of achieving good seizure control and improving behavioural disorders in selected cases. To date, the number of treated cases is still too small to draw final conclusions. Radiosurgery is still in search of an optimized radiation dose, localization, and target volume.