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01.04.2010 | Original Article

Treatment and outcome of children with cerebral cavernomas: a survey on 32 patients

verfasst von: Alessandro Consales, Gianluca Piatelli, Marcello Ravegnani, Marco Pavanello, Pasquale Striano, Maria Luisa Zoli, Valeria Capra, Andrea Rossi, Maria Luisa Garrè, Maria Grazia Calevo, Armando Cama

Erschienen in: Neurological Sciences | Ausgabe 2/2010

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Abstract

We prospectively followed-up 32 pediatric patients with cerebral cavernomas (CCs) to better define surgical indications in this population. Three groups of patients were identified: (a) children with macrohemorrhage (21 patients, 65.6%), (b) children with localized or diffuse headache (6 patients, 18.8%) and (c) children with epilepsy (5 patients, 15.6%). Surgery was performed in 28 out of the 32 (87.5%) subjects. New transient post-operative neurological deficits were observed in two children. One child developed a post-operative hematoma. At a median follow-up of 4 years (range 1–11 years), 22 out of the 28 (78.6%) operated patients were in good conditions. All operated subjects with epilepsy were seizure-free. We confirm the high risk of macrohemorrhage in pediatric CCs. Surgery is mostly recommended in accessible cavernomas, except for small, asymptomatic deep-seated CCs or for punctuate lesions without bleeding signs.

Clatterbuck RE, Eberhart CG, Crain BJ et al (2001) Ultrastructural and immunocytochemical evidence that an incompetent blood–brain barrier is related to the pathophysiology of cavernous malformations. J Neurol Neurosurg Psychiatry 71:188–192CrossRefPubMed

McCormick WF (1984) Pathology of vascular malformations of the brain. In: Wilson CB, Stein BM (eds) Intracranial vascular malformations. Williams and Wilkins, Baltimore, pp 44–63

Zabramski JM, Henn JS, Coons S (1999) Pathology of cerebral vascular malformations. Neurosurg Clin N Am 10:395–410PubMed

Aiba T, Tanaka R, Koike T et al (1995) Natural history of intracranial cavernous malformations. J Neurosurg 83:56–59CrossRefPubMed

Chadduck WM, Binet EF, Farrell FW Jr et al (1985) Intraventricular cavernous hemangioma: report of three cases and review of the literature. Neurosurgery 16:189–197PubMed

Del Curling O Jr, Kelly DL Jr, Elster AD Jr et al (1991) An analysis of the natural history of cavernous angiomas. J Neurosurg 75:702–708CrossRefPubMed

Raychaudhuri R, Batjer HH, Awad IA (2005) Intracranial cavernous angioma: a practical review of clinical and biological aspects. Surg Neurol 63:319–328CrossRefPubMed

Simard JM, Garcia-Bengochea F, Ballinger WE Jr et al (1986) Cavernous angioma: a review of 126 collected and 12 new clinical cases. Neurosurgery 18:162–172CrossRefPubMed

Steiger HJ, Markwalder TM, Reulen HJ (1987) Clinicopathological relations of cerebral cavernous angiomas: observations in eleven cases. Neurosurgery 21:879–884CrossRefPubMed

10.

Vaquero J, Leunda G, Martinez R et al (1983) Cavernomas of the brain. Neurosurgery 12:208–210CrossRefPubMed

11.

Yamasaki T, Handa H, Yamashita J et al (1986) Intracranial and orbital cavernous angioma. A review of 30 cases. J Neurosurg 64:197–208CrossRefPubMed

12.

Buckingham MJ, Crone KR, Ball WS et al (1989) Management of cerebral cavernous angiomas in children presenting with seizures. Childs Nerv Syst 5:347–349CrossRefPubMed

13.

Di Rocco C, Iannelli A, Tamburrini G (1996) Cavernomas of the central nervous system in children. A report of 22 cases. Acta Neurochir (Wien) 138:1267–1274CrossRef

14.

Edwards MSB, Baumgartner JE, Wilson CB (1993) Cavernous and other cryptic vascular malformations in the paediatric age group. In: Awad IA, Barrow DL (eds) Cavernous malformations. AANS Publications Committee, Park Ridge, pp 163–183, pp 185–186

15.

Fortuna A, Ferrante L, Mastronardi L et al (1989) Cerebral cavernous angioma in children. Childs Nerv Syst 5:201–207CrossRefPubMed

16.

Giulioni M, Acciarri N, Padovani R et al (1994) Surgical management of cavernous angiomas in children. Surg Neurol 42:194–199CrossRefPubMed

17.

Maraire JN, Awad IA (1995) Intracranial cavernous malformations: lesion behavior and management strategies. Neurosurgery 37:591–605CrossRefPubMed

18.

Mazza C, Scienza R, Beltramello A et al (1991) Cerebral cavernous malformations (cavernomas) in the paediatric age-group. Childs Nerv Syst 7:139–146CrossRefPubMed

19.

Scott RM (1990-1991) Brain stem cavernous angiomas in children. Pediatr Neurosurg 16:281–286

20.

Scott RM, Barnes P, Kupsky W et al (1992) Cavernous angiomas of the central nervous system in children. J Neurosurg 76:38–46CrossRefPubMed

21.

Herter T, Brandt M, Szüwart U (1988) Cavernous hemangiomas in children. Childs Nerv Syst 4:123–127CrossRefPubMed

22.

D’Angelo VA, De Bonis C, Amoroso R et al (2006) Supratentorial cerebral cavernous malformations: clinical, surgical and genetic involvement. Neurosurg Focus 21:e9PubMed

23.

Labauge P, Laberge S, Brunereau L et al (1998) Hereditary cerebral cavernous angiomas: clinical and genetic features in 57 French families. Société Française de Neurochirurgie. Lancet 352:1892–1897

24.

Mathiesen T, Edner G, Kihlström L (2003) Deep and brainstem cavernomas: a consecutive 8-year series. J Neurosurg 99:31–37CrossRefPubMed

25.

Robinson JR, Awad IA (1993) Clinical spectrum and natural course. In: Awad IA, Barrow DL (eds) Cavernous malformations. AANS Publications Committee, Park Ridge, pp 25–36

26.

Tomlinson FH, Houser OW, Scheithauer BW et al (1994) Angiographically occult vascular malformations: a correlative study of features on magnetic resonance imaging and histological examination. Neurosurgery 34:792–800CrossRefPubMed

27.

Smit LM, Halbertsma FJ (1997) Cerebral cavernous hemangiomas in childhood. Clinical presentation and therapeutic considerations. Childs Nerv Syst 13:522–525CrossRefPubMed

28.

Mottolese C, Hermier M, Stan H et al (2001) Central nervous system cavernomas in the paediatric age group. Neurosurg Rev 24:55–73CrossRefPubMed

29.

Hubert P, Choux M, Houtteville JP (1989) Cavernomes cérébraux de l’enfant et du nourrisson. Neurochirurgie 35:104–105PubMed

30.

Mazza C, Scienza R, Dalla Bernardin B et al (1989) Malformations caverneuses cérébrales (cavernomes) de l’enfant. Neurochirurgie 35:106–108PubMed

31.

Tung H, Giannotta SL, Chandrasoma PT et al (1990) Recurrent intraparenchymal hemorrhages from angiographically occult vascular malformations. J Neurosurg 73:174–180CrossRefPubMed

32.

Di Rocco C, Iannelli A, Tamburrini G (1997) Cavernous angiomas of the brain stem in children. Pediatr Neurosurg 27:92–99CrossRefPubMed

33.

Fritschi JA, Reulen HJ, Spetzler RF et al (1994) Cavernous malformations of the brain stem. A review of 139 cases. Acta Neurochir (Wien) 130:35–46CrossRef

34.

Lange SC, Neafsey EJ, Wyler AR et al (1980) Neuronal activity in chronic ferric chloride epileptic foci in cats and monkey. Epilepsia 21:251–254CrossRefPubMed

35.

Rigamonti D, Hadley MN, Drayer BP et al (1988) Cerebral cavernous malformations. Incidence and familial occurrence. N Engl J Med 319:343–347PubMedCrossRef

36.

Cohen DS, Zubay GP, Goodman RR et al (1995) Seizure outcome after lesionectomy for cavernous malformations. J Neurosurg 83:237–242CrossRefPubMed

37.

Ferroli P, Casazza M, Marras C et al (2006) Cerebral cavernomas and seizures: a retrospective study on 163 patients who underwent pure lesionectomy. Neurol Sci 26:390–394CrossRefPubMed

38.

Noto S, Fujii M, Akimura T et al (2005) Management of patients with cavernous angiomas presenting epileptic seizures. Surg Neurol 64:495–499CrossRefPubMed

39.

Gaensler EH, Dillon WP, Edwards MS et al (1994) Radiation-induced telangiectasia in the brain simulates cryptic vascular malformations at MR imaging. Radiology 193:629–636PubMed

40.

Humpl T, Brühl K, Bohl J et al (1997) Cerebral haemorrhage in long-term survivors of childhood acute lymphoblastic leukaemia. Eur J Pediatr 156:367–370CrossRefPubMed

41.

Nyáry I, Major O, Hanzély Z et al (2005) Histopathological findings in a surgically resected thalamic cavernous hemangioma 1 year after 40-Gy irradiation. J Neurosurg 102(Suppl):56–58CrossRefPubMed

42.

Larson JJ, Ball WS, Bove KE et al (1998) Formation of intracerebral cavernous malformations after radiation treatment for central nervous system neoplasia in children. J Neurosurg 88:51–56CrossRefPubMed

43.

Nimjee SM, Powers CJ, Bulsara KR (2006) Review of the literature on de novo formation of cavernous malformations of the central nervous system after radiation therapy. Neurosurg Focus 21:e4CrossRefPubMed

44.

Amin-Hanjani S, Ogilvy CS, Candia GJ et al (1998) Stereotactic radiosurgery for cavernous malformations: Kiellberg’s experience with proton beam therapy in 98 cases at the Harvard Cyclotron. Neurosurgery 42:1229–1238CrossRefPubMed

45.

Karlsson B, Kihlström L, Lindquist C et al (1988) Radiosurgery for cavernous malformations. J Neurosurg 88:293–297

46.

Mitchell P, Hodgson TJ, Seaman S et al (2000) Stereotactic radiosurgery and the risk of haemorrhage from cavernous malformations. Br J Neurosurg 14:96–100CrossRefPubMed

47.

Pollock BE, Garces YI, Stafford SL et al (2000) Stereotactic radiosurgery for cavernous malformations. J Neurosurg 93:987–991CrossRefPubMed

Titel: Treatment and outcome of children with cerebral cavernomas: a survey on 32 patients
verfasst von: Alessandro Consales
Gianluca Piatelli
Marcello Ravegnani
Marco Pavanello
Pasquale Striano
Maria Luisa Zoli
Valeria Capra
Andrea Rossi
Maria Luisa Garrè
Maria Grazia Calevo
Armando Cama
Publikationsdatum: 01.04.2010
Verlag: Springer Milan
Erschienen in: Neurological Sciences / Ausgabe 2/2010
Print ISSN: 1590-1874
Elektronische ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-009-0157-0

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Erratum to: Treatment and outcome of children with cerebral cavernomas: a survey on 32 patients