Cerebral cavernomas in the adult: Review of the literature and analysis of 61 surgically treated patients

Abstract

Background and Purpose. Authors review the latest data regarding modern, multimodal management of single and multiple intracranial cavernomas, based on their experience, on a consecutive series of 61 cases. Methods. During 2001 to 2009, 61 patients (33 men, 28 women) with intracerebral cavernous angiomas underwent surgical treatment in our center, and they were included into the present uncontrolled clinical study. The average age of the patients at the time of operation was 41.4 years. All patients underwent preoperative magnetic resonance imaging, and pre and postoperative clinical examination. The clinical course was documented using the Karnofski performance scale. A simplified version of Engel’s classification of the outcome of the patients with chronic seizures was applied. Results. The most common clinical presentation of cavernous angiomas was seizures, significant part of which was chronic. In the group of patients presenting with headache, sporadic seizures, or intracerebral hemorrhage, good postoperative outcome was achieved in 86.84% of the patients. Of the patients who underwent operation for seizure control, significant seizure reduction or elimination after surgery was observed in 80,95% of the patients. Conclusions. Cavernomas are benign lesions, surgically resectable; the excision must be complete, any rests causing re-bleeding. Microsurgical removal of cavernous angiomas and surrounding hemosiderin plate tends to significant reduction or elimination of epileptic seizures and improved postoperative neurological status.