Figure 1
(a) Postoperative T2-weighted axial MRI demonstrating bilateral DBS lead placement in the posterior subthalamic area. The enlarged inset delineates anatomical boundaries of the subthalamic nucleus (STN) and red nucleus (RN). (b) Corresponding T2-weighted image showing the radiofrequency lesion in the left ventrolateral thalamus (Vim).
Supplementary Video
Severity of patient’s tremor before leads implantation, during intraoperative macrostimulation, after initial programming, after 12 months of unsuccessful stimulation adjustments and 10 months after thalamotomy.
Figure 2
3D reconstruction of DBS leads (silver) and thalamotomy lesion (necrotic core (purple) and perilesional edema (pink)) registered to Essential Tremor Probabilistic Mapping atlas in MNI space. Lead trajectories intersect the decussating fibers of the cerebellothalamic tract (CTT, red) bilaterally, while the lesion core localizes in the Vim of the left thalamus (white transparent). (Coordinate space: MNI152; visualization software: Lead-DBS v3.2).