Figure 2.

The patient underwent placement of the Leksell stereotactic head frame without difficulty. This was followed by obtaining a high-resolution stereotactic MRI scan of the brain. Contrast-enhanced T1-weighted axial images were obtained at 2 mm intervals. The images were transferred into the treatment planning workstation and reviewed. The previously identified enhanced lesions involving the hypothalamus were observed. Operative procedure: the team proceeded with outlining the visible lesion and developing a treatment plan. A single dose calculation matrix was used. The hypothalamic lesion was treated using 9 shots with 4 and 8 mm collimator helmets. The volume target was 2.6 cm³, and the prescription isodose was 11 Gy. White to the 50% isodose line. Note: 100% of the tumor received the prescription isodose. Brain stem < 11 Gy, left optic nerve < 7.8 Gy, and right optic nerve < 5.1 Gy.