Brain Glucose Metabolism with [¹⁸F]-Fluorodeoxyglucose and Positron Emission Tomography before and after Surgical Resection of Epileptogenic Cavernous Angiomas

Abstract

Surgery of cavernous angiomas is often proposed due to the epileptogenic and hemorrhagic potential of this lesion. Little information is available on the impact of surgical resection on brain metabolism, locally or at a distance from the lesion. Fifteen patients presenting with a cavernoma and epileptic seizures underwent positron emission tomography examinations before and 1 year after surgical resection. We studied the quantitative cerebral metabolic rate of glucose (CMRGlu) with [¹⁸F]-fluorodeoxyglucose. The global brain CMRGlu remained unchanged after surgery. There was a significant decrease of metabolism in the lesion hemisphere, which remained unchanged after surgery. The perilesional regions were less metabolic than the contralateral ones and less metabolic than remote regions within the same hemisphere, before and after surgery. The absence of pre- to postsurgical variations suggests that the metabolic consequences of the lesion are maintained despite the surgical procedure during long-term follow-up studies.

Memory network plasticity after temporal lobe resection: a longitudinal functional imaging study

“…These changes could represent a ‘release’ phenomenon with reversal of a functional or metabolic disruption. Functional imaging studies such as fluorodeoxyglucose-PET showed a normalization of glucose metabolism in the ipsilateral temporal cortex ( Gogoleva et al , 1997 ), inferior frontal lobe, thalamus and parietal lobe ( Spanaki et al , 2000 ; Takaya et al , 2009 ) following temporal lobe surgery.…”

Progressive white matter changes following anterior temporal lobe resection for epilepsy

“…FDG-PET shows a normalization of glucose metabolism in the remaining ipsilateral temporal cortex (Gogoleva et al, 1997) and extratemporal regions including the inferior frontal lobe, thalamus and parietal lobe (Spanaki et al, 2000; Takaya et al, 2009) following surgery. Moreover, magnetic resonance spectroscopy shows that N-acetylaspartate (NAA)/creatine (Cr) ratios normalize in the ipsilateral (Cendes et al, 1997; Serles et al, 2001) and contralateral (Hugg et al, 1996; Lantz et al, 2006) temporal cortex in patients rendered seizure free by surgery.…”

Surgical management of simultaneous supra- and infratentorial hemorrhages in a pediatric patient with multiple cavernomas

“…3) The perilesional hemosiderin-laden parenchyma is the cause of seizures in most cases. 6) On the other hand, more than 90% of patients with infratentorial cavernomas have neurological improvement. 14) To date, only four cases of multiple simultaneous hemorrhages in cavernomas have been reported in the literature.…”