Magnetic Resonance Image Guided Focused Ultrasound Thalamotomy for Essential Tremor in a Patient with an Arteriovenous Malformation.

BACKGROUND

Magnetic Resonance Guided Focused Ultrasound Thalamotomy (MRgFUS) is a non-surgical treatment option for medically refractory Essential Tremor (ET) or tremor dominant Parkinson's Disease.

CASE REPORT: A 75-year-old left-handed man with medically refractory essential tremor presented for MRgFUS evaluation. During workup, contrast-enhanced brain MRI revealed an incidental right frontal arteriovenous malformation. After discussion of management options, the patient elected not to pursue treatment of the newly diagnosed AVM and proceeded with tremor-focused therapy.

DISCUSSION: It is possible to effectively utilize MRgFUS for treatment of tremors in carefully selected patients with cerebral AVMs by designating the malformation as a no pass zone.