Brain stem cavernous malformations.
We retrospectively reviewed the clinical experience of 30 patients with brain stem cavernous malformations (BSCM) treated operatively and non-operatively at our hospital between 1983 and 2005 to elucidate the natural history of BSCM and the factors that affect surgical outcome. Inpatient charts, imaging studies, operative records, and follow-up results were evaluated. The average follow up was 48.5 months. Twenty-two patients (73.3%) received surgical extirpation and of these 86.4% improved or stabilized and 13.6% deteriorated with permanent or severe morbidity. There was no mortality. Size, preoperative status, and surgical timing were factors related to surgical outcome. In the non-operative group, 50% of the patients were the same or better, 25% deteriorated, and 25% died. With appropriate patient selection, resection of BSCM can be achieved with acceptable morbidity compared with the ominous natural history of these lesions.
Huang
Abel Po-Hao
AP
Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung Shan South Road, Taipei 100, Taiwan.
Chen
Jui-Sheng
JS
Yang
Chi-Cheng
CC
Wang
Kuo-Chuan
KC
Yang
Shih-Hung
SH
Lai
Dar-Ming
DM
Tu
Yong-Kwang
YK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001933:Brain Stem / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D020526:Brain Stem Infarctions / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D020295:Brain Stem Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D002536:Cerebral Arteries / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D002550:Cerebral Veins / Q000002:abnormalities / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult