Treatment of epileptogenic cavernomas: surgery versus radiosurgery.
BACKGROUND
Epilepsy is the most common symptom of cavernoma. Although microsurgery is the mainstay treatment for epileptogenic cavernoma, this procedure may cause severe complications for some lesions. This report aimed to study if linear accelerator (LINAC) radiosurgery was an alternative treatment modality for epileptogenic cavernoma.


METHODS
In this retrospective study, 29 patients were diagnosed with epileptogenic cavernomas from September 1995 to March 2005. Fifteen patients were treated with surgical excision and 14 with LINAC radiosurgery. The evaluation of epilepsy control was according to Engel's classification.


RESULTS
In the surgical group, 13 (86.7%) of 15 patients had a class I seizure-free outcome. In the radiosurgery group, class I control was achieved in 9 (64.3%) of 14 patients. However, there was no significant difference in the results of treatment between the two groups.


CONCLUSIONS
LINAC radiosurgery is an alternative treatment for epileptogenic cavernomas, especially when the lesions are located in the central regions or eloquent areas of the brain.
Hsu
Peng-Wei
PW
Brain Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Tao Yuan, Taiwan, ROC.
Chang
Cheng-Nen
CN
Tseng
Chen-Kan
CK
Wei
Kuo-Cheng
KC
Wang
Chun-Chieh
CC
Chuang
Chi-Cheng
CC
Huang
Yin-Cheng
YC
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery*; D004827:Epilepsy / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D016634:Radiosurgery / Q000295:instrumentation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome