Cavernous hemangiomas in children

Herter, Th.; Brandt, Matthias; Szuwart, Ulrich

doi:10.1007/bf00270900

Cited by 45 publications

(21 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the literature, CMs account for about 20% of all CNS vascular malformations [15,16,17], and 25% of them are reported in the pediatric age group [6, 7, 15, 18, 19]. …”

Section: Resultsmentioning

confidence: 99%

“…Clinical results in children treated with surgical therapy for CMs of the CNS are generally excellent or good in the majority of pediatric series [7, 10,12,13,14,15, 20, 24, 29, 31, 36, 67, 168, 173]; in a recent review of the literature, 68.2% of children treated did not have any clinical sequelae after surgery [10]. Excellent results have also been reported in newborns and children under 1 year of age [13, 27, 29, 30, 32, 46, 195].…”

Section: Resultsmentioning

confidence: 99%

“…Since the introduction of magnetic resonance (MR) imaging, these vascular lesions have been widely reported in the literature, and their natural history is now better defined [2,3,4]. CMs have been estimated to be present in about 0.4–0.8% of the population [3, 5, 6]; one fourth of CMs affect pediatric patients [2,7,8,9], in whom these malformations represent 1.7–18% of all vascular growths [10]. In the pediatric age group, CMs have been reported to be one of the main causes of brain hemorrhage [11] and the most common surgically treated cerebrovascular malformation [10,12,13,14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cavernous Malformations of the Central Nervous System in the Pediatric Age Group

et al. 2009

View full text Add to dashboard Cite

Objective: The main clinico-diagnostic features, risk factors and associated diseases of cavernous malformations (CMs), also called cavernous angiomas or cavernomas, of the central nervous system (CNS) in children are described, and the most relevant differences compared to the affected adult population are pointed out, focusing on the management of pediatric patients harboring cranial and spinal CMs. Materials: This was a retrospective study of a series of 42 children symptomatic for CMs of the cranial and spinal compartments (35 supratentorial brain lesions, 5 infratentorial and 2 in the spinal region) operated on between 1975 and 2005, with a clinical follow-up ranging from 12 to 192 months. The results were compared with those found in the most recent literature dealing with pediatric CMs of the CNS. Results: Surgical treatment produced excellent or good results in 69% of our 42 children. Unchanged neurological deficits were observed in 23.8% of cases, while morbidity from surgical procedures was 7.14%. Mortality was absent in this series. These surgical results are comparable with those found in the literature, where morbidity and mortality rates from surgery are 8.8 and 1.13%, respectively, and are mostly associated with procedures for the excision of deep, critically located cavernomas. Conclusion: CMs represent the most common CNS vascular lesion in children, although their incidence is 4 times lower than that of the adult population. The natural history of pediatric CMs throughout the neuraxis seems to be more aggressive than in adult patients; these lesions have higher rates of growth and hemorrhage, larger dimensions and often atypical radiological pictures at diagnosis. Beside the familial form of the disease, which is more often associated with multiple lesions and an earlier age of clinical presentation, the major risk factor for CMs in children seems to be radiotherapy for CNS tumors. Furthermore, a greater number of CMs coexistent with mixed angiomatous lesions have been reported in children than in adults. Surgical results are related to the preoperative neurological status of the children; symptomatic patients who are operated on early, before they develop severe neurological deficits or long-standing seizures, may achieve the best clinical outcome. Radiosurgery does not seem to be advisable in children as an alternative treatment for deep CMs or those causing epilepsy.

show abstract

“…In the literature, CMs account for about 20% of all CNS vascular malformations [15,16,17], and 25% of them are reported in the pediatric age group [6, 7, 15, 18, 19]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cavernous Malformations of the Central Nervous System in the Pediatric Age Group

et al. 2009

View full text Add to dashboard Cite

show abstract

“…The prevalence of CM in children is estimated to be between 0.37 and 0.53% [3,4]. These lesions are well circumscribed and consist of irregular, thick- and thin-walled, sinusoidal vascular channels located within the brain but lacking intervening neural parenchyma.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Brain Cavernomas in Children

Alexiou¹,

Mpairamidis²,

Sfakianos³

et al. 2009

Pediatr Neurosurg

View full text Add to dashboard Cite

Background: Cavernous hemangiomas are benign vascular hamartomas caused by developmental malformations of the vascular bed. They can be found in 0.3–0.7% of the population, whereas one fourth of these lesions occur in children. Methods: In the present study, we report on 16 cases of cavernomas surgically treated in our institute. From each patient’s file, the age, sex, lesion location, symptoms and follow-up were analyzed. Results: The most commonly presenting symptom was epilepsy. Radiological signs of acute hemorrhage were observed in 3 cases. Three children had multiple cavernomas. The parietal lobe was the most common site of occurrence, whereas only 2 cavernomas were infratentorial. There was no operative mortality. Postoperatively, there was no additional neurological deficit, and all patients gradually improved. In a case of pontine cavernoma, there was a need for reoperation due to rebleeding. Conclusion: With the improvement of microsurgical techniques and modern neuroimaging, nearly all cavernomas can be safely removed. Total resection is associated with patients’ clinical improvement and seizure control.

show abstract

“…Extracting patient data from previous reports (9 series with 189 patients) demonstrates consistent, exceedingly high complete resection rates for these lesions (99% overall) ( Table 3). 2,5,10,12,13,15,19,27 Improved intraoperative navigation, intraoperative ultrasound, and now intraoperative MRI are key components to achieving this statistic. Our 2 cases of incomplete resection represent exceptional cases-one with a lesion entirely embedded in motor cortex without a safe corridor of access ( Fig.…”

Section: 512mentioning

confidence: 99%

Resection of supratentorial lobar cavernous malformations in children

Gross¹,

Smith²,

Goumnerova³

et al. 2013

PED

View full text Add to dashboard Cite

Object The authors present a series of children with supratentorial lobar cavernous malformations (CMs). Current imaging and operative techniques along with long-term follow-up were incorporated to characterize the response to surgical treatment in this pediatric population. Methods The senior author's operative experience was reviewed retrospectively along with a review of the Boston Children's Hospital database from 1997 to 2011 for children with supratentorial lobar CMs. Lobar CM was defined as having a supratentorial location but not involving the thalamus/hypothalamus or basal ganglia. Baseline patient demographics, pertinent radiographic findings, operative outcomes, and long-term results were evaluated and compared between patients managed operatively and those who were managed nonoperatively. Results Of 238 CMs identified, 181 (76%) were lobar. Compared with patients managed with observation only, those selected for surgery were older (p = 0.03), more likely to have symptomatic lesions (p < 0.001), and had larger lesions (p < 0.001). Of the 83 CMs selected for surgery, 98% were completely resected. Over a total of 384.5 patient-years of follow-up after surgery (mean 4.6 years; median 2.7 years; range 0.1–22.3 years), there were no subsequent hemorrhages in any patient undergoing complete resection; 1 of the 2 incompletely resected lesions rebled during the follow-up period. Radiographically, there was 1 recurrence (1.2%) in a child with multiple CMs; there were no recurrences of completely resected single lesions. Of the 48 patients who presented with seizures (acute or chronic), 46 (96%) were seizure free at follow-up. The permanent neurological complication rate of surgery was 5%; these complications were limited to those patients whose lesions were in eloquent locations. Conclusions Pediatric patients with symptomatic supratentorial lobar CMs are ideal candidates for surgery, for which there are high complete resection rates, rewarding long-term seizure outcomes, and low operative morbidity. Observation may be warranted in smaller asymptomatic lesions located within eloquent cortex.

show abstract

Cavernous hemangiomas in children

Cited by 45 publications

References 18 publications

Cavernous Malformations of the Central Nervous System in the Pediatric Age Group

Cavernous Malformations of the Central Nervous System in the Pediatric Age Group

Surgical Management of Brain Cavernomas in Children

Resection of supratentorial lobar cavernous malformations in children

Contact Info

Product

Resources

About