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01-09-2017 | Original Paper

Cavernous malformations of central nervous system in pediatric patients: our single-centered experience in 50 patients and review of literature

Authors: Dattaraj Paramanand Sawarkar, Suveen Janmatti, Rajinder Kumar, Pankaj Kumar Singh, Hitesh Kumar Gurjar, Shashank Sharad Kale, Bhawani Shanker Sharma, Ashok Kumar Mahapatra

Published in: Child's Nervous System | Issue 9/2017

Abstract

Purpose

Cavernous malformations (CMs) are rare developmental cerebrovascular malformations of the central nervous system with a childhood prevalence of 0.3 to 0.53%. Our purpose was to assess the clinical features and microsurgical outcome in pediatric central nervous system (CNS) CMs.

Material and methods

We retrospectively enrolled all the CM patients admitted to our institute from 1 January 2001 to 31 December 2014. Data was analyzed for their clinical features and surgical outcome.

Results

A total of 50 patients with CMs (30 supratentorial, 14 infratentorial, and 6 spinal) with a mean age of 14 years (3–18 years, SD ±4.64) were enrolled into the study. Most of these patients (78%) were male. Size varied from 1.2 to 6 cm. Three patients had multiple CMs. Symptoms of CMs were site specific. Seizure was the most common symptom (63.3%) of CMs at supratentorial location followed by headache (46%) and neurodeficiency (26%), while all brainstem and spinal CMs presented with neurodeficiencies. History of clinically significant acute hemorrhage was present in 19.2% of supratentorial (ST) superficial CMs, 50% of ST deep CMs, 25% of cerebellar CMs, 44.4% of brainstem CMs, and 50% of spinal CMs. Forty-five CMs in 44 patients were surgically excised. Their follow-up ranged from 6 to 162 months (mean 47.2 months, SD ±53). All supratentorial CM patients showed improvement in their symptoms. Patients with preoperative seizure showed good seizure control with Engel scale I in 16 (94.1%) and Engel scale II in 1 (5.9%). In infratentorial (IT) and spinal CM patients, 92.3 and 66.7% had improvement in their neurodeficiencies, respectively. There was no mortality in our series.

Conclusion

Microsurgical excision of CNS CM results in excellent neurological outcome in pediatric patients. Early intervention is necessary in spinal CMs for better outcome.

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Title: Cavernous malformations of central nervous system in pediatric patients: our single-centered experience in 50 patients and review of literature
Authors: Dattaraj Paramanand Sawarkar
Suveen Janmatti
Rajinder Kumar
Pankaj Kumar Singh
Hitesh Kumar Gurjar
Shashank Sharad Kale
Bhawani Shanker Sharma
Ashok Kumar Mahapatra
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 9/2017
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-017-3429-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Cavernous malformations of central nervous system in pediatric patients: our single-centered experience in 50 patients and review of literature

Abstract

Purpose

Material and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Material and methods

Results

Conclusion

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