Cavernous malformations of the central nervous system (CNS) in children: clinico-radiological features and management outcomes of 36 cases
| Autor: | Kader Karli Oguz, Sahin Hanalioglu, Burcak Bilginer, Nejat Akalan, Figen Soylemezoglu, Firat Narin |
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| Rok vydání: | 2014 |
| Předmět: |
Central Nervous System
Male medicine.medical_specialty Adolescent Central nervous system Population Neurosurgical Procedures Retina Epilepsy Seizures medicine Humans Child education Retrospective Studies Central Nervous System Vascular Malformations education.field_of_study business.industry Age Factors Brain Infant General Medicine Cavernous malformations medicine.disease Magnetic Resonance Imaging Occult Surgery Treatment Outcome medicine.anatomical_structure Child Preschool Radiological weapon Pediatrics Perinatology and Child Health Female Neurology (clinical) Neurosurgery Presentation (obstetrics) business Follow-Up Studies |
| Zdroj: | Child's Nervous System. 30:1355-1366 |
| ISSN: | 1433-0350 0256-7040 |
| Popis: | Cavernous malformations (CMs) of the central nervous system (CNS) are angiographically occult vascular lesions that affect approximately 0.5 % of the general population, and one quarter of all CMs occurs in children. We retrospectively analyzed demographic, clinical, radiological, management, and follow-up data of 36 pediatric patients with CMs from a single institution. The mean age of the children at first presentation and at operation was 8.7 and 9.6 years, respectively. However, a bimodal age distribution was found with peak under 4 years and above 12 years. Seizure was the most common single presenting symptom (38.9 %), and 61.1 % of patients had at least one seizure before the admission. Focal neurological deficits (410.7 %), intracranial hypertension (27.8 %), and headache (2.8 %) were the other manifestations. Acute/subacute hemorrhage was evident at presentation in 63.9 %. The patients under 6 years of age were found to have significantly more giant cavernomas (69 vs 20 %; p = 0.011), and more overt hemorrhages (81 vs 47 %; p = 0.065) at diagnosis than those patients above 12 years. Surgery was performed in 31 patients (32 CMs), with 26 total and 6 incomplete resections. Mean follow-up duration was 6.9 ± 4.1 years. Of all patients, 63.8 % had excellent and 30.5 % had good clinical outcomes, and also 90.9 % of the epileptic patients were seizure-free (Engel Class I) at the last follow-up. Younger children tend to harbor larger CMs and present with hemorrhage more frequently than older ones. Microsurgical resection should be the treatment of choice in symptomatic and accessible CMs. |
| Databáze: | OpenAIRE |
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