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This procedure is done while the patient is awake. The MRI allows the physician to precisely plan, guide, and target a small, specific area of your brain. The MRI also precisely measures the increased temperature in the brain caused by the ultrasound energy. This allows it to precisely treat only the intended target.

This is an ideal treatment tool because ultrasound energy can pass through skin, muscle, fat, and bone without incisions (cuts). Ultrasound energy is also non-ionizing, meaning that you are not exposed to potentially dangerous radiation during the procedure.

Before Treatment

You will meet with one of our care team nurses to prepare you for the procedure. Your nurse will take your vital signs and fully shave your head (as required) for surgery. They will also place an IV tube (in your vein or intravenously) in your arm to give you any needed medications and a urinary cathether in your bladder, so you won’t have to go to the bathroom during the procedure.

You will be given numbing medication before a frame is placed on your head by your neurosurgeon. This head frame attaches to the MRI table to prevent any movement during the procedure. A silicon membrane is then placed on the head to allow for circulation of cool water. This will minimize potential heating near the scalp.

Your heart rate, blood pressure, and blood oxygen levels will be monitored throughout the procedure.

Planning the Treatment

Next, you will lie on the bed that will move you in and out of the MRI device. You will be conscious throughout the procedure so you can communicate with the physicians and nurses, and your specialists will perform the procedure from a computer in the room next to the MRI suite. They will be able to monitor you with a camera while a nurse monitors your vital signs to ensure you are doing well.

To plan the procedure, MRI images will be obtained so that your physician can locate the area to be treated. Small doses of ultrasound energy will be given to help confirm proper targeting in the brain.

You will be given a 'Stop' button to hold during the procedure, so you can pause the treatment at any time. Cool water from your helmet will circulate around the top of your head to prevent heating from the ultrasound.

During Treatment

During the sonication treatment, your physician will ask you questions and have you perform tasks like writing or tracing lines to confirm the tremor is improving.

Once your physician is confident of the location, the focused ultrasound energy will be increased in the same location to make the improvement in tremor permanent.

The procedure typically lasts a few hours. The time depends on many factors including density of your skull.

After Treatment

After coming out of the MRI machine, we will remove the frame from your head before scanning a few more images to confirm the location of the treatment. After these images, you will be moved to a recovery room. Most patients will be able to go home later that day.

Before discharge, monitoring equipment will be removed and you will receive specific discharge instructions from your doctor. Usually nothing is required, although your doctor may recommend steroids.

Your physician will let you know when you need to return for any follow-up visits. You will also be told whom to contact in case of an emergency after the procedure.