title: Prognostic factors for post-operative seizure outcomes after cavernous malformation treatment.
abstract: Although patients with cerebral cavernous malformations may remain asymptomatic, they often present with neurological symptoms of headache, hemorrhage and, most commonly, seizure. A review of articles published between 1985 and 2009 was performed to elucidate the prognostic factors which may predict post-operative seizure control. The following characteristics were found to consistently correlate with a more favorable post-operative seizure-free outcome: (i) extent of resection of the cavernous malformation and its surrounding hemosiderin rim; (ii) single or sporadic seizures compared to chronic epilepsy; (iii) illness duration less than 1 or 2 years; and (iv) size of cavernous malformation less than 1.5 cm. Radiosurgery may achieve post-operative seizure-free rates ranging from 25% to 64.3%, and may be an alternative to surgical resection for deep or eloquent cavernous malformations, or those in patients with co-morbidities. There was no clear association between post-operative seizures and either lesion location, age, or gender. Prognostic features of cavernous malformations should be utilized for both guidance of lesion treatment, and prediction of post-operative seizure outcomes.
authors.affiliation: Department of Neurological Surgery, University of California Los Angeles, 695 Charles E. Young Drive South, Gonda Room 3357, Los Angeles, California 90095-1761, USA.
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Stephanie
authors.initials: S
authors.lastname: Stramotas
authors.forename: Winward
authors.initials: W
authors.lastname: Choy
authors.forename: Justin
authors.initials: J
authors.lastname: Dye
authors.forename: Daniel
authors.initials: D
authors.lastname: Nagasawa
authors.forename: Isaac
authors.initials: I
authors.lastname: Yang
mesh_terms: D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures; D011379:Prognosis; D012640:Seizures / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome