Laser interstitial thermal therapy, also referred to as laser ablation, is a minimally invasive technique for precisely burning tissue in the body. It can be used in various organs, including the liver and prostate; I use it for certain disorders of the brain.

There are two main steps in a laser ablation procedure. In the first step, a small, temporary anchor is affixed to the skull. The anchor is inserted with millimeter precision, and it serves to aim the laser fiber toward a target in the brain. In the second step of the procedure, a laser fiber is inserted with the patient asleep in an MRI machine. The laser is then used to coagulate (burn) diseased brain tissue using the MRI to provide real-time feedback.

Laser ablation is a minimally invasive alternative to craniotomy that can be used for a variety of brain lesions. I use it most commonly for epilepsy. It is a flexible tool that can also be used for lesions such as cavernous malformations, certain brain tumors, and radiation necrosis. Laser ablation is best-suited for small lesions in the brain.

Below on the page is an image of a case I performed illustrating what a laser ablation lesion looks like on an MRI after the procedure.

Laser ablation is performed under general anesthesia. There is no need to shave more than a tiny patch of hair, and the incision is only a few millimeters long and can be closed with a single absorbable stitch. Patients generally stay one night in the hospital and can leave the following day. Headaches are common in the first few days after the procedure; these tend to respond to steroid medications, which I give to all patients.