MR-guided Laser Interstitial Thermal Therapy mesencephalotomy for medically intractable malignant pain.

Aubignat, Mickael; Constans, Jean-Marc; Ouendo, Martial; Arnault, Jean-Philippe; Josse, Claire; Desenclos, Christine; Lefranc, Michel · Acta Neurochir (Wien) · 2025

case_report · Level V

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Abstract

Stereotactic mesencephalotomy is a neurosurgical technique designed to sever spinothalamic pain transmission pathways for medically intractable pain. This report presents the first case of Magnetic Resonance-guided Laser Interstitial Thermal Therapy (MRgLITT) mesencephalotomy for severe malignant pain due to metastatic melanoma. The procedure significantly reduced the patient's pain, with a postoperative visual analog scale (VAS) score decreasing from > 7 to < 3. No adverse effects were observed. The case underscores the potential of MRgLITT mesencephalotomy as a precise, minimally invasive option for pain management in palliative care settings.

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