Microsurgical removal of supratentorial and cerebellar cavernous malformations : what has changed? A single institution experience
Copyright © 2024 Elsevier Ltd. All rights reserved..
BACKGROUND: Features associated with a safe surgical resection of cerebral cavernous malformations (CMs) are still not clear and what is needed to achieve this target has not been defined yet.
METHODS: Clinical presentation, radiological features and anatomical locations were assessed for patients operated on from January 2008 to January 2018 for supratentorial and cerebellar cavernomas. Supratentorial CMs were divided into 3 subgroups (non-critical vs. superficial critical vs. deep critical). The clinical outcome was assessed through modified Rankin Scale (mRS) and was divided into favorable (mRS 0-1) and unfavorable (mRS ≥ 2). Post-operative epilepsy was classified according to the Maraire Scale.
RESULTS: A total of 144 were considered eligible for the current study. At 6 months follow-up the clinical outcome was excellent for patients with cerebellar or lobar CMs in non-critical areas (mRS ≤ 1: 91.1 %) and for patients with superficial CMs in critical areas (mRS ≤ 1: 92.3 %). Patients with deep-seated suprantentorial CMs showed a favorable outcome in 76.9 %. As for epilepsy 58.5 % of patients presenting with a history of epilepsy were free from seizures and without therapy (Maraire grade I) at last follow-up (mean 3.9 years) and an additional 41.5 % had complete control of seizures with therapy (Maraire grade II).
CONCLUSIONS: Surgery is safe in the management of CMs in non-critical but also in critical supratentorial locations, with a caveat for deep structures such as the insula, the basal ganglia and the thalamus/hypothalamus.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:123 |
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| Enthalten in: |
Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia - 123(2024) vom: 10. Apr., Seite 162-170 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Meneghelli, Pietro [VerfasserIn] |
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| Links: |
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| Themen: |
Cavernous malformation |
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| Anmerkungen: |
Date Completed 25.04.2024 Date Revised 25.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jocn.2024.04.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370711831 |
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| 500 | |a Date Revised 25.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Features associated with a safe surgical resection of cerebral cavernous malformations (CMs) are still not clear and what is needed to achieve this target has not been defined yet | ||
| 520 | |a METHODS: Clinical presentation, radiological features and anatomical locations were assessed for patients operated on from January 2008 to January 2018 for supratentorial and cerebellar cavernomas. Supratentorial CMs were divided into 3 subgroups (non-critical vs. superficial critical vs. deep critical). The clinical outcome was assessed through modified Rankin Scale (mRS) and was divided into favorable (mRS 0-1) and unfavorable (mRS ≥ 2). Post-operative epilepsy was classified according to the Maraire Scale | ||
| 520 | |a RESULTS: A total of 144 were considered eligible for the current study. At 6 months follow-up the clinical outcome was excellent for patients with cerebellar or lobar CMs in non-critical areas (mRS ≤ 1: 91.1 %) and for patients with superficial CMs in critical areas (mRS ≤ 1: 92.3 %). Patients with deep-seated suprantentorial CMs showed a favorable outcome in 76.9 %. As for epilepsy 58.5 % of patients presenting with a history of epilepsy were free from seizures and without therapy (Maraire grade I) at last follow-up (mean 3.9 years) and an additional 41.5 % had complete control of seizures with therapy (Maraire grade II) | ||
| 520 | |a CONCLUSIONS: Surgery is safe in the management of CMs in non-critical but also in critical supratentorial locations, with a caveat for deep structures such as the insula, the basal ganglia and the thalamus/hypothalamus | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cavernous malformation | |
| 650 | 4 | |a Clinical management | |
| 650 | 4 | |a Intraoperative neurophysiology | |
| 650 | 4 | |a Surgery | |
| 700 | 1 | |a Pasqualin, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Musumeci, Angelo |e verfasserin |4 aut | |
| 700 | 1 | |a Pinna, Giampietro |e verfasserin |4 aut | |
| 700 | 1 | |a Berti, Pier Paolo |e verfasserin |4 aut | |
| 700 | 1 | |a Polizzi, Giuseppe Maria Valerio |e verfasserin |4 aut | |
| 700 | 1 | |a Sinosi, Filippo Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Nicolato, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Sala, Francesco |e verfasserin |4 aut | |
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