Cerebral cavernomas and seizures: a retrospective study on 163 patients who underwent pure lesionectomy
| Autor: | Marina Casazza, Paolo Ferroli, Angelo Franzini, C. Mendola, C. Marras, Giovanni Broggi |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Microsurgery Neurology Adolescent Dermatology Neurosurgical Procedures Hemangioma Angioma Epilepsy Seizures medicine Humans Neuroradiology Retrospective Studies business.industry Brain Neoplasms Retrospective cohort study General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Psychiatry and Mental health Image-guided surgery Hemangioma Cavernous Treatment Outcome Female Neurology (clinical) Neurosurgery business |
| Zdroj: | Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 26(6) |
| ISSN: | 1590-1874 |
| Popis: | The objective was to evaluate the outcome of microsurgical "pure" lesionectomy in patients with supratentorial cavernous angiomas presenting with seizures. For this retrospective study 163 patients with cavernoma-related epileptic seizures were selected. They all underwent surgery in a single institution between 1988 and 2003. A microsurgical frame/frameless guided minimally invasive transulcal "pure" lesionectomy was performed. The haemosiderin stained gliotic brain parenchyma that was usually found surrounding the lesion was not removed. Among the 99 patients with epilepsy and longer clinical history, 68 (68.7%) were found completely to be seizure-free, 10 (10.1%) presented sporadic and less frequent seizures and 17 (17.1%) remained unchanged. Sixty-three out of 64 (98.4%) patients who experienced only single or sporadic seizures were found to be completely seizure-free after surgery. Five patients were lost at follow-up (mean 48 months, range 0.5-14 years). Long-term morbidity was 1.8%. Mortality was null. No haemorrhagic episodes were observed during follow-up. Pure lesionectomy prevents bleeding and development of epilepsy in patients that receive early surgery after the epileptic onset. In most of the epileptic patients with a good concordance between the electroclinical data and the location of the angioma, good results can be achieved by this kind of surgery so that more invasive and costly studies to find and remove the epileptogenic cerebral parenchyma seem justified only after lesionectomy fails. |
| Databáze: | OpenAIRE |
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