Microsurgery and Radiosurgery for Brainstem Cavernomas: Effective and Complementary Treatment Options

Frischer, Josa M.; Gatterbauer, Brigitte; Holzer, Sabrina; Stavrou, Ioannis; Gruber, Andreas; Novak, Klaus; Wang, Wei-Te; Reinprecht, Andrea; Mert, Ayguel; Trattnig, Siegfried; Mallouhi, Ammar; Kitz, K.; Knosp, Engelbert

doi:10.1016/j.wneu.2014.01.004

Cited by 38 publications

(25 citation statements)

References 23 publications

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“…Due to the increased complication risk, the main criteria for selecting surgery are severe clinical presentation, including hemorrhage, and location within 2 mm from pial surface. In case the lesion has severe clinical presentation but is deeply seated, surgery is selected only if the lesion is large and accessible [ 48 , 49 ]. Frischer et al resected BSCM lesions with a median volume of 2 cm 3 when a microsurgical corridor was available [ 48 ].…”

Section: Microsurgical Resectionmentioning

confidence: 99%

Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

Mouchtouris

Chalouhi

Chitale

et al. 2015

The Scientific World Journal

144

115

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Cerebral cavernous malformations are the most common vascular malformations and can be found in many locations in the brain. If left untreated, cavernomas may lead to intracerebral hemorrhage, seizures, focal neurological deficits, or headaches. As they are angiographically occult, their diagnosis relies on various MR imaging techniques, which detect different characteristics of the lesions as well as aiding in planning the surgical treatment. The clinical presentation and the location of the lesion are the most important factors involved in determining the optimal course of treatment of cavernomas. We concisely review the literature and discuss the advantages and limitations of each of the three available methods of treatment—microsurgical resection, stereotactic radiosurgery, and conservative management—depending on the lesion characteristics.

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Section: Microsurgical Resectionmentioning

confidence: 99%

Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

Mouchtouris

Chalouhi

Chitale

et al. 2015

The Scientific World Journal

144

115

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“…Kraujavimu pasireiškia apie 10-25 % kavernomų [5]. Smegenų kamieno kavernomų kasmetinis pakraujavimo dažnis yra nuo 2,3 % iki 4,1 % [6].…”

Section: Gydymo Metodaiunclassified

Galvos smegenų kaverninė malformacija

Beržanskis¹,

Macytė²,

Šustickas³

2017

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Galvos smegenų kaverninė malformacija (KM, kavernoma, kaverninė angioma, kaverninė hemangioma) -tai įgimtas krauja gyslinis darinys, sudarytas iš kompaktiškai išsidėsčiusio išsiplėtusių kapiliarų rezginio, kuriame nėra smegenų parenchimos. Dažnai kavernomų simptomatikos pasireiškimas susijęs su pakraujavimu. Tačiau kavernomos gali būti besimptomės, jos nu statomos atsitiktinai. Kasmetinis kamieno kavernomų pakraujavimo dažnis -nuo 2,3 % iki 4,1 %.Todėl dauguma sunkių ži dinių tampa neurochirurgijos centrų tikslu. Giliai esančių bei kamieno židinių chirurgija yra ne tokia sėkminga. Kavernomų simptomatika priklauso nuo židinio lokalizacijos. Apie 80 % atvejų kavernomos yra viršdangtinės. Dažniausiai pažeidžiamos kaktinė bei smilkininė skiltys, požievinė zona. Būdingiausi simptomai yra epilepsija ir traukuliai. Šie simptomai yra susiję su kaverninės malformacijos pakraujavimu. Renkantis chirurginį gydymą svarbu įvertinti židinio anatomiją ir lokalizaciją atlikus magnetinio rezonanso tomografiją (MRT). Radikalus kavernomos chirurginis pašalinimas yra vienintelis veiksmingas gydymo metodas.MRT yra jautriausias ir specifiškiausias kavernomų diagnostikos metodas. Mažas kavernomas rutininiu MRT gali būti sunku diagnozuoti. Reikšminiai žodžiai: Galvos smegenų kaverninė malformacija, kavernoma, kaverninė angioma, kaverninė hemangioma Cerebral cavernous malformations (CCM) are lowflow vascular lesions in eloquent locations. Their presentation is often marked with symptomatic hemorrhages. Annual brainstem CM rate of hemorrhage is from 2.3% to 4.1%. Surgery for deepseated or brainstem lesions is less successful and is associated with an early morbidity rate of roughly 30-70% and a mortality rate of 2%. Signs and symptoms of CCM depends on localization in the brain. Approximately 80% of cases are supratentorial caverno mas. The most frequent injuring zones are frontal, temporal lobes and subcortical region. The most common symptoms are epilepsy and seizures. Also it can effect motor fibers which are situated in the cerebellum branch. Statistically approximately 40% all of CCM are asymptomatic and found accidentally when radiological investigations are taken.

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“…This poses a significant challenge in image registration for open craniotomies. However, once resolved, this methodology will provide an objective means of comparing parameters can affect how physicians utilize stereotactic radiosurgery in treatment of brain tumors, 87,88 arterio-venous malformations, 89 and cavernous malformations 90 by augmenting current understanding of treatment related MR changes.…”

Section: Image Acquisitionmentioning

confidence: 99%