Hypothalamic Hamartomas

Neuropathological Features with and without Prior Gamma Knife Radiosurgery

John F. Kerrigan, Angela Parsons, Stephen G. Rice, Kristina A. Simeone, Andrew G. Shetter, Adib A. Abla, Erin Prenger, Stephen W. Coons

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The neuropathological consequences of Gamma Knife radiosurgery (GK) on hypothalamic hamartoma (HH) are unknown. Objective: In a cohort of patients undergoing surgery for treatment-resistant epilepsy, we compared surgically resected HH tissue from patients without (group I; n = 19) and with (group II; n = 10) a history of GK (median dose 16 Gy to the 50% isodose margin). Methods: Techniques included thick-section stereology for total nucleated and total neuron cell counts, and thin-section immunohistochemistry. Normal human hypothalamus derived from age-matched autopsy material was used as control tissue for CD68 immunohistochemistry. Qualitative scoring of tissue sections was performed by a neuropathologist who was blind to the GK treatment history. Results: GK is associated with decreased total cell density (p <0.02). A dose-dependent association of GK with decreased total neuron density approached significance (p = 0.06). Group II HH tissue had significantly more (1) reactive gliosis, (2) thickened capillary endothelium and (3) microglial activation. Degenerative features, including karyorrhexis and pyknotic nuclei, were infrequent in group II and absent in group I HH tissue. Conclusions: Nonnecrotizing doses of GK radiosurgery decrease cell density in human HH tissue. Cell loss resulting from GK may contribute to decreased excitation in the neuronal networks responsible for seizure onset in HH tissue.

Original languageEnglish
Pages (from-to)45-55
Number of pages11
JournalStereotactic and Functional Neurosurgery
Volume91
Issue number1
DOIs
StatePublished - Jan 2013

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Radiosurgery
Cell Count
Immunohistochemistry
Neurons
Gliosis
Hypothalamic hamartomas
Vascular Endothelium
Hypothalamus
Autopsy
Epilepsy
Seizures
History
Therapeutics

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery

Cite this

Hypothalamic Hamartomas : Neuropathological Features with and without Prior Gamma Knife Radiosurgery. / Kerrigan, John F.; Parsons, Angela; Rice, Stephen G.; Simeone, Kristina A.; Shetter, Andrew G.; Abla, Adib A.; Prenger, Erin; Coons, Stephen W.

In: Stereotactic and Functional Neurosurgery, Vol. 91, No. 1, 01.2013, p. 45-55.

Research output: Contribution to journalArticle

Kerrigan, John F. ; Parsons, Angela ; Rice, Stephen G. ; Simeone, Kristina A. ; Shetter, Andrew G. ; Abla, Adib A. ; Prenger, Erin ; Coons, Stephen W. / Hypothalamic Hamartomas : Neuropathological Features with and without Prior Gamma Knife Radiosurgery. In: Stereotactic and Functional Neurosurgery. 2013 ; Vol. 91, No. 1. pp. 45-55.
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