Neurosurgical management of cerebellar cavernous malformations.
OBJECTIVE
The aim of this study was to analyze cerebellar cavernous malformations (CMs) with respect to epidemiological, clinical, radiological, and therapeutic aspects.


METHODS
Between 1984 and 2004, 100 patients were surgically treated for intracranial CMs at the Division of Neurosurgery of Federal University of Sao Paulo. The authors reviewed the records of 10 patients whose lesions were located in the cerebellum. There were four male and six female patients (ratio 1:1.5) whose ages ranged from 14 to 45 years (mean age 33 years). Clinical presentation was sudden or acute in all cases, and neuroimaging examinations performed in all patients demonstrated signs of bleeding. The mean size of the malformations was 4.6 cm, and in all but one patient the lesions were totally removed without complications. After a mean follow-up period of 70 months, all patients were considered to be in good or excellent clinical condition.


CONCLUSIONS
Cerebellar CMs should be analyzed separately from other posterior fossa CMs. These lesions can reach large sizes and cause massive hemorrhages, resulting in acute or sudden presentation. Surgery is a safe and effective option that provides a curative treatment when a complete removal is achieved.
de Oliveira
Jean G
JG
Division of Neurosurgery, Department of Neurology and Neurosurgery, Federal University of São Paulo--Escola Paulista de Medicina, São Paulo, Brazil. jeangol@uol.com.br
Rassi-Neto
Aziz
A
Ferraz
Fernando A P
FA
Braga
Fernando M
FM
D000208:Acute Disease / Q000628:therapy; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002528:Cerebellar Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002531:Cerebellum / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery*; D002550:Cerebral Veins / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D003388:Cranial Fossa, Posterior / Q000033:anatomy & histology / Q000601:surgery; D003952:Diagnostic Imaging / Q000592:standards; D018450:Disease Progression; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods* / Q000592:standards; D012189:Retrospective Studies; D017678:Sex Distribution; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods* / Q000592:standards