Surgical Approaches for Symptomatic Cerebral Cavernous Malformations of the Thalamus and Brainstem
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 19-35, 2017.
Article
Dans Anglais
| WPRIM
| ID: wpr-185797
ABSTRACT
OBJECTIVE:
Surgical resection of thalamic and brainstem cerebral cavernous malformations (CCMs) is associated with significant operative morbidity, but it may be outweighed, in some cases, by the neurological damage from recurrent hemorrhage in these eloquent areas. The goals of this retrospective cohort study are to describe the technical nuances of surgical approaches and determine the postoperative outcomes for CCMs of the thalamus and brainstem. MATERIALS ANDMETHODS:
We reviewed an institutional database of patients harboring thalamic or brainstem CCMs, who underwent surgical resection from 2010 to 2014. The baseline and follow-up neuroimaging and clinical findings of each patient and the operative details of each case were evaluated.RESULTS:
A total of eight patients, including two with thalamic and six with brainstem CCMs, were included in the study cohort. All patients had progressive neurological deterioration from recurrent CCM hemorrhage, and the median modified Rankin Scale (mRS) at presentation was 3. The median CCM maximum diameter and volume were 1.7 cm and 1.8 cm³, respectively. The thalamic CCMs were resected using the anterior transcallosal transchoroidal and supracerebellar infratentorial approaches each in one case (13%). The brainstem CCMs were resected using the retrosigmoid and suboccipital trans-cerebellomedullary fissure approaches each in three cases (38%). After a median follow-up of 11.5 months, all patients were neurologically stable or improved, with a median mRS of 2. The rate of functional independence (mRS 0-2) was 63%.CONCLUSION:
Microneurosurgical techniques and approaches can be safely and effectively employed for the management of thalamic and brainstem CCMs in appropriately selected patients.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Thalamus
/
Tronc cérébral
/
Études rétrospectives
/
Études de cohortes
/
Études de suivi
/
Hémangiome caverneux du système nerveux central
/
Hémorragies intracrâniennes
/
Anomalies vasculaires
/
Neuroimagerie
/
Hémorragie
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Etude d'incidence
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Journal of Cerebrovascular and Endovascular Neurosurgery
Année:
2017
Type:
Article
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