Treatment and outcome of children with cerebral cavernomas: a survey on 32 patients.
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.
Consales
Alessandro
A
Department of Neurosurgery, Gaslini Children's Hospital, Genoa, Italy.
Piatelli
Gianluca
G
Ravegnani
Marcello
M
Pavanello
Marco
M
Striano
Pasquale
P
Zoli
Maria Luisa
ML
Capra
Valeria
V
Rossi
Andrea
A
Garrè
Maria Luisa
ML
Calevo
Maria Grazia
MG
Cama
Armando
A
D000293:Adolescent; D001921:Brain / Q000473:pathology / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000235:genetics / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D020786:Hemangioma, Cavernous, Central Nervous System / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012306:Risk; D012640:Seizures / Q000235:genetics / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome