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6408704 
Journal Article 
Giant hypothalamic hamartoma operated through subfrontal approach with orbitary rim osteotomy 
Miranda, P; Esparza, J; Cabrera, A; Hinojosa, J 
2006 
1 
Pediatric Neurosurgery
ISSN: 1016-2291
EISSN: 1423-0305 
42 
4 
254-257 
English 
16714869 
WOS:000243060700011 
INTRODUCTION: Hypothalamic hamartomas are associated with precocious puberty, gelastic seizures and severe refractory epilepsy. Treatment options include surgical resection, radiofrequency and radiosurgery.

CASE REPORT: A 7-month-old girl presented with gelastic seizures and developmental delay related to a giant hypothalamic hamartoma. The patient was operated through a subfrontal approach. Intraoperatively the lesion appeared intimately adherent to the right internal carotid artery. Seizure control was improved after tumoral decompression.

CONCLUSIONS: Treatment of giant hypothalamic hamartomas should always include surgical resection, given the mass effect over surrounding vital structures. Subfrontal approach with orbitary rim osteotomy provides a wide exposure with minimal frontal lobe retraction. Close adherence of hypothalamic hamartoma to vascular structures may be present, requiring careful surgical manipulation. 
giant hypothalamic hamartoma, subfrontal approach; gelastic seizures