Surgical Treatment of Supratentorial Cerebral Cavernomas Manifested by Seizures
DOI:
https://doi.org/10.22141/2224-0713.2.72.2015.78358Keywords:
supratentorial cavernomas, seizures, drug resistance, perifocal hemosiderosisAbstract
Background. Cerebral cavernomas are a group of rare vascular malformations of the brain. Approximately 80 % of cavernomas of the central nervous system have supratentorial localization. The main clinical symptom of supratentorial cavernomas is seizure.
Objective. To assess the outcomes of surgical treatment for cerebral cavernomas manifested by seizures.
Materials and Methods. The study included 29 patients who were treated on the basis of three clinics from November 2010 till January 2015. All patients had supratentorial cavernomas which lead to seizures. Duration of the disease before surgery was from 1 to 84 months (mean 27 months). In all cases cavernomas were resected with the zone of perifocal hemosiderosis, and these malformations were sent to histological assessment. Treatment outcomes were assessed by Engel scale.
Results. 25 patients (86.2 %) had Engel I and II classes. In all patients with single seizures, seizures disappeared completely (Engel I), while in patients with a long epileptic history such result was achieved in only 46.7 % of cases. Only in a half of patients (6 of 12, 50 %) with secondary generalized seizures, seizures disappeared completely (Engel I). In the subgroup of patients with drug-resistant epilepsy 2 patients we included into the group Engel II, 2 — Engel IIІ, 1 — Engel IV.
Conclusions. Surgical treatment of supratentorial cerebral cavernomas manifested by seizures is an effective and safe therapy. Resection of cavernoma in patients with epileptic seizures should be complemented by resection of perifocal hemosiderosis zone.
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Copyright (c) 2016 V.I. Smolanka, M.Ye. Polishchuk, T.A. Malysheva, A.A. Oblyvach, O.M. Vozniak, A.V. Smolanka, T.O. Studeniak
This work is licensed under a Creative Commons Attribution 4.0 International License.