title: Transcranial MR-guided focused ultrasound sonothrombolysis in the treatment of intracerebral hemorrhage.
abstract: Intracerebral hemorrhage remains a significant cause of morbidity and mortality. Current surgical therapies aim to use a minimally invasive approach to remove as much of the clot as possible without causing undue disruption to surrounding neural structures. Transcranial MR-guided focused ultrasound (MRgFUS) surgery is an emerging technology that permits a highly concentrated focal point of ultrasound energy to be deposited to a target deep within the brain without an incision or craniotomy. With appropriate ultrasound parameters it has been shown that MRgFUS can effectively liquefy large-volume blood clots through the human calvaria. In this review the authors discuss the rationale for using MRgFUS to noninvasively liquefy intracerebral hemorrhage (ICH), thereby permitting minimally invasive aspiration of the liquefied clot via a small drainage tube. The mechanism of action of MRgFUS sonothrombolysis; current investigational work with in vitro, in vivo, and cadaveric models of ICH; and the potential clinical application of this disruptive technology for the treatment of ICH are discussed.
authors: Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA. stephen.monteith@gmail.com
authors: Stephen J
authors: SJ
authors: Monteith
authors: Neal F
authors: NF
authors: Kassell
authors: Oded
authors: O
authors: Goren
authors: Sagi
authors: S
authors: Harnof
mesh_terms: D000818:Animals; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D004195:Disease Models, Animal; D006801:Humans; D008279:Magnetic Resonance Imaging; D017131:Thrombectomy / Q000295:instrumentation / Q000379:methods; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D014463:Ultrasonography