Computer-Assisted Resection of Supra-Tentorial Cavernous Malformation

Conrad, Marcelo D.; Schonauer, Claudio; Morel, Christian; Pélissou-Guyotat, I.; Deruty, R

doi:10.1055/s-2002-32485

Cited by 15 publications

(3 citation statements)

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“…There is general agreement in the literature that surgery is not indicated for asymptomatic CMs, especially when they are deeply placed or located in eloquent CNS areas [2,3,4, 10, 64, 65, 68, 107, 113, 151, 152, 166, 167]. However, asymptomatic CMs in children require special attention, since the natural history of pediatric lesions is less predictable, and they appear to be more aggressive with regard to hemorrhage and growth than in adults [13, 14].…”

Section: Resultsmentioning

confidence: 99%

“…Cortical and subcortical brain CMs should be removed using the smallest corticotomy possible or, when feasible, through a sulcus. Nowadays, neuronavigation has taken the place of intraoperative sonography, which was used in the past for localizing subcortical cerebral CMs; furthermore, a neuronavigation device can assist and contribute to the removal of small, deep CMs and may also help in planning the best incision point for the least invasive surgical route [166, 183]. …”

Section: Resultsmentioning

confidence: 99%

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Cavernous Malformations of the Central Nervous System in the Pediatric Age Group

et al. 2009

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Objective: The main clinico-diagnostic features, risk factors and associated diseases of cavernous malformations (CMs), also called cavernous angiomas or cavernomas, of the central nervous system (CNS) in children are described, and the most relevant differences compared to the affected adult population are pointed out, focusing on the management of pediatric patients harboring cranial and spinal CMs. Materials: This was a retrospective study of a series of 42 children symptomatic for CMs of the cranial and spinal compartments (35 supratentorial brain lesions, 5 infratentorial and 2 in the spinal region) operated on between 1975 and 2005, with a clinical follow-up ranging from 12 to 192 months. The results were compared with those found in the most recent literature dealing with pediatric CMs of the CNS. Results: Surgical treatment produced excellent or good results in 69% of our 42 children. Unchanged neurological deficits were observed in 23.8% of cases, while morbidity from surgical procedures was 7.14%. Mortality was absent in this series. These surgical results are comparable with those found in the literature, where morbidity and mortality rates from surgery are 8.8 and 1.13%, respectively, and are mostly associated with procedures for the excision of deep, critically located cavernomas. Conclusion: CMs represent the most common CNS vascular lesion in children, although their incidence is 4 times lower than that of the adult population. The natural history of pediatric CMs throughout the neuraxis seems to be more aggressive than in adult patients; these lesions have higher rates of growth and hemorrhage, larger dimensions and often atypical radiological pictures at diagnosis. Beside the familial form of the disease, which is more often associated with multiple lesions and an earlier age of clinical presentation, the major risk factor for CMs in children seems to be radiotherapy for CNS tumors. Furthermore, a greater number of CMs coexistent with mixed angiomatous lesions have been reported in children than in adults. Surgical results are related to the preoperative neurological status of the children; symptomatic patients who are operated on early, before they develop severe neurological deficits or long-standing seizures, may achieve the best clinical outcome. Radiosurgery does not seem to be advisable in children as an alternative treatment for deep CMs or those causing epilepsy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cavernous Malformations of the Central Nervous System in the Pediatric Age Group

et al. 2009

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“…To the best of our knowledge, there is no previous report in the English-language literature focusing on the details of image guidance in surgery for insular cavernoma. Most reports deal with the application of neuronavigation for surgery of supratentorial cavernous malformation (8,11,18,23,27,32,40). It was the aim of the present study to describe the technique of image guidance for surgery of insular cavernomas in more detail.…”

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confidence: 99%