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Effective surgical treatment of cerebral cavernous malformations: a multicenter study of 79 pediatric patients


Hugelhofer, M; Acciarri, N; Sure, U; Baumgartner, R W; Bertalanffy, H; Siegel, A M (2011). Effective surgical treatment of cerebral cavernous malformations: a multicenter study of 79 pediatric patients. Journal of Neurosurgery. Pediatrics, 8(5):522-525.

Abstract

OBJECT: Cerebral cavernous malformations (CCMs) are common vascular lesions in the brain, affecting approximately 0.5% of the population and representing 10%-20% of all cerebral vascular lesions. One-quarter of all CCMs affect pediatric patients, and CCMs are reported as one of the main causes of brain hemorrhage in this age group. Symptoms include epileptic seizures, headache, and focal neurological deficits. Patients with symptomatic CCMs can be treated either conservatively or with resection if lesions cause medically refractory epilepsy or other persistent symptoms.

METHODS: The authors retrospectively analyzed 79 pediatric patients (41 boys and 38 girls) from 3 different centers, who were surgically treated for their symptomatic CCMs between 1974 and 2004. The mean age of the children at first manifestation was 9.7 years, and the mean age at operation was 11.3 years. The main goal was to compare the clinical outcomes with respect to the location of the lesion of children who preoperatively suffered from epileptic seizures.

RESULTS: Of these patients, 77.3% were seizure free (Engel Class I) after the resection of the CCM. Significant differences in the outcome between children who harbored CCMs at different locations were not found.

CONCLUSIONS: Resection seems to be the favorable treatment of symptomatic CCMs not only in adults but also in children.

OBJECT: Cerebral cavernous malformations (CCMs) are common vascular lesions in the brain, affecting approximately 0.5% of the population and representing 10%-20% of all cerebral vascular lesions. One-quarter of all CCMs affect pediatric patients, and CCMs are reported as one of the main causes of brain hemorrhage in this age group. Symptoms include epileptic seizures, headache, and focal neurological deficits. Patients with symptomatic CCMs can be treated either conservatively or with resection if lesions cause medically refractory epilepsy or other persistent symptoms.

METHODS: The authors retrospectively analyzed 79 pediatric patients (41 boys and 38 girls) from 3 different centers, who were surgically treated for their symptomatic CCMs between 1974 and 2004. The mean age of the children at first manifestation was 9.7 years, and the mean age at operation was 11.3 years. The main goal was to compare the clinical outcomes with respect to the location of the lesion of children who preoperatively suffered from epileptic seizures.

RESULTS: Of these patients, 77.3% were seizure free (Engel Class I) after the resection of the CCM. Significant differences in the outcome between children who harbored CCMs at different locations were not found.

CONCLUSIONS: Resection seems to be the favorable treatment of symptomatic CCMs not only in adults but also in children.

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10 citations in Web of Science®
11 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:November 2011
Deposited On:02 Feb 2012 21:16
Last Modified:05 Apr 2016 15:32
Publisher:American Association of Neurological Surgeons
ISSN:1933-0707 (P) 1933-0715 (E) 1933-0707 (L)
Publisher DOI:10.3171/2011.8.PEDS09164
Official URL:http://thejns.org/doi/abs/10.3171/2011.8.PEDS09164?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
PubMed ID:22044379
Permanent URL: http://doi.org/10.5167/uzh-57962

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