In preparation for treatment, your doctor will order a specialized CT scan to understand your skull anatomy (which can affect your treatment eligibility).
On the day of surgery, the patient is given a mild sedative and pain medication before treatment. A stereotactic frame will be placed on your head to enable exact targeting and to prevent your head from moving during the procedure. At this time, your entire scalp will be shaved and cleaned, to enable adequate cooling of the scalp. You will be placed in a specialized MR scanner with an MRgFUS helmet that contains a cooling system as well as the ultrasound sources. During treatment, it is normal to feel a warming sensation. You will be awake throughout the procedure and your tremor will be evaluated after each treatment (or sonication). Once the target is confirmed, a lesion is created in a focused manner using ultrasound energy. Patient will be informed when images are being acquired (scanning) and when the system is sonicating (treatment). The clinical team, made of the physicians, nurses, and technologists, will be communicating with the patient using a microphone and a speaker. Your heart rate, blood pressure and blood oxygen levels will be monitored throughout the procedure.
During the procedure, ultrasound waves are focused to a specific point in the part of the brain that is believed to cause tremors. These focused ultrasound waves create a tiny ablation or burn that will cause the improvement in tremor. The entire procedure is conducted inside an MRI scanner which functions as the eyes of the treatment. MRI provides images to plan, treat and verify complete ablation of target. The treatment lasts about 3 hours during which you are awake and can give feedback on the treatment effect in real-time.
Following the treatment, the patient would be asked to rest for a couple of hours in the clinic, while the light sedation wears off. Once cleared by the nursing staff, the patient is released to go home.