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Open Access 07-05-2024 | Epilepsy | Research

Surgical management of lobar cerebral cavernous malformations in children: a single-center experience

Authors: Ryszard Sordyl, Lukasz Antkowiak, Marta Rogalska, Michael Schroter, Izabela Rosol, Marcin Ciekalski, Antonina Radolinska, Marek Mandera

Published in: Child's Nervous System

Abstract

Purpose

We aimed to determine the surgical indications and postoperative outcomes among pediatric patients with lobar cerebral cavernous malformations (CCMs).

Methods

We retrospectively reviewed pediatric patients operated on for lobar CCM between March 2010 and August 2021. Indications for surgery included (1) intracranial hemorrhage, (2) symptomatic superficially located lesion, and (3) asymptomatic CCM in non-eloquent area in case of strong parental preferences. Patients presenting with seizures were assessed using Engel Epilepsy Surgery Outcome Scale.

Results

Twenty-one patients were included. The predominant symptoms were seizures (57.1%), headaches (33.3%), and focal neurological deficits (23.8%). Patients were qualified for surgery due to symptomatic intracranial hemorrhage (47.6%), drug-resistant epilepsy (28.6%), and focal neurological deficits (9.5%). Three patients (14.3%) were asymptomatic. A gross total resection of CCM with the surrounding hemosiderin rim was achieved in all patients. The mean follow-up was 52 months. No patient experienced surgery-related complications. In all individuals with a preoperative first episode of seizures or focal neurological deficits, the symptoms subsided. All six patients with drug-resistant epilepsy improved to Engel classes I (67%) and II (33%).

Conclusion

Surgical removal of symptomatic lobar CCMs in properly selected candidates remains a safe option. Parental preferences may be considered a sole qualifying criterion for asymptomatic lobar CCM excision.

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Title: Surgical management of lobar cerebral cavernous malformations in children: a single-center experience
Authors: Ryszard Sordyl
Lukasz Antkowiak
Marta Rogalska
Michael Schroter
Izabela Rosol
Marcin Ciekalski
Antonina Radolinska
Marek Mandera
Publication date: 07-05-2024
Publisher: Springer Berlin Heidelberg
Keywords: Epilepsy
Headache
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Hemangioma
Published in: Child's Nervous System
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-024-06433-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Surgical management of lobar cerebral cavernous malformations in children: a single-center experience

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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