PMC9062951_01
Stereoencephalography electrode placement. (a) Anterior view of bilateral electrode placement in frontal and temporal lobes with insular and cingulate coverage. Yellow and blue lines represent electrodes targeting the cingulate gyrus and non-cingulate regions respectively. (b) Left cingulate electrode coverage with the cingulate gyrus highlighted in yellow.
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F1
The patient underwent a sEEG study with bilateral frontotemporal and parietal coverage including the insular cortex and CC [Figure 1]. ACC, MCC, and posterior CC to better localize the epileptogenic foci within the cingulate gyrus [Figure 1]. After expanding left CC coverage, six seizures were captured, all localized to the left ACC and MCC. For the MCC trajectory, six pull backs were performed to cover the entire region [Figure 2, Video 1].
Laser interstitial thermal therapy trajectory and ablation volume. (a) Sagittal view of the left anterior cingulate trajectory. (b) Coronal view of left anterior cingulate trajectory. (c) Sagittal view of the left middle cingulate trajectory. (d) Axial view of the left middle cingulate trajectory. Orange mask over the brain indicates the ablation volume of the trajectory.
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F2
For the MCC trajectory, six pull backs were performed to cover the entire region [Figure 2, Video 1].
Sagittal view of cingulate after laser ablation.
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F3
Total ablation volume was 17.86 cm3 [Figure 3].