Cavernous malformations of the central nervous system (CNS) in children: clinico-radiological features and management outcomes of 36 cases

Bilginer, Burçak; Narin, Fırat; Hanalıoğlu, Şahin; Oğuz, Kader K.; Söylemezoğlu, Figen; Akalan, Nejat

doi:10.1007/s00381-014-2442-3

Cited by 26 publications

(19 citation statements)

References 36 publications

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“…6 Cavernous malformations comprise about 20% of all intracranial and intraspinal vascular malformations, and one-fourth of them are reported under 18 years of age. 8,9 The mean age at symptom onset in our series was 9.3 years, which was similar to the literature. 5,10 It has been reported that there exists a bimodal age distribution in pediatric cavernous malformations: in the age group of 0-3 and 11-16 years.…”

Section: Discussionsupporting

confidence: 89%

“…Second, it is reported that cavernous malformation patients with a prior hemorrhage history have a significantly increased risk of bleeding at the rate of 4.5% to 22.6% per year. 9 Third, pediatric patients have a longer life expectancy, which results in a higher accumulative risk than adult counterparts. Fourth, frontal lobe cavernous malformations locate at accessible sites, and the surgical risk is relatively low.…”

Section: Discussionmentioning

confidence: 99%

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Frontal Lobe Cavernous Malformations in Pediatric Patients: Clinical Features and Surgical Outcomes

et al. 2018

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The purpose of this study is to investigate the clinical manifestations, surgical treatment, and neurologic outcomes of frontal lobe cavernous malformations in children. A retrospective analysis of 23 pediatric frontal lobe cavernous malformation patients who underwent surgical treatment in Beijing Tiantan Hospital was performed. The case series included 16 boys and 7 girls. Gross total removal without surgical mortality was achieved in all patients. The mean follow-up period after surgery was 33.1 months. Two patients who left hospital with motor deficits gradually recovered after rehabilitative treatment, and other patients were considered to be in excellent clinical condition. For symptomatic frontal lobe cavernous malformations, neurosurgical management should be the treatment of choice. Conservative treatment may be warranted in asymptomatic frontal lobe cavernous malformations, especially the deep-seated or eloquently located cases.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Frontal Lobe Cavernous Malformations in Pediatric Patients: Clinical Features and Surgical Outcomes

et al. 2018

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“…Resection is generally recommended for symptomatic easily accessible CCMs given the increased risk of rebleed after first hemorrhage, and the low morbidity associated with surgery. 87 , 88 Other considerations are needed for CCMs involving the visual pathways, 89 , 90 and those involving the lateral ventricle. 91 …”

Section: Neurosurgical Considerationsmentioning

confidence: 99%

Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel

et al. 2017

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BACKGROUND: Despite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies. OBJECTIVE: To develop guidelines for CCM management. METHODS: The Angioma Alliance (www.angioma.org), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations. The group reviewed literature, rated evidence, developed recommendations, and established consensus, controversies, and knowledge gaps according to a prespecified protocol. RESULTS: Of 1270 publications published between January 1, 1983 and September 31, 2014, we selected 98 based on methodological criteria, and identified 38 additional recent or relevant publications. Topic authors used these publications to summarize current knowledge and arrive at 23 consensus management recommendations, which we rated by class (size of effect) and level (estimate of certainty) according to the American Heart Association/American Stroke Association criteria. No recommendation was level A (because of the absence of randomized controlled trials), 11 (48%) were level B, and 12 (52%) were level C. Recommendations were class I in 8 (35%), class II in 10 (43%), and class III in 5 (22%). CONCLUSION: Current evidence supports recommendations for the management of CCM, but their generally low levels and classes mandate further research to better inform clinical practice and update these recommendations. The complete recommendations document, including the criteria for selecting reference citations, a more detailed justification of the respective recommendations, and a summary of controversies and knowledge gaps, was similarly peer reviewed and is available on line www.angioma.org/CCMGuidelines.

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“…Because of the benign biological behavior and clear lesion boundaries with the surrounding brain tissue, it is suitable for surgical resection [1,10]. However, for cavernous hemangioma deep within the hemisphere, especially lesions involving important structures, surgery is also controversial [7].…”

Section: Discussionmentioning

confidence: 99%

Paraventricular or centrum ovale cavernous hemangioma involving the pyramidal tract in children: intraoperative MRI and functional neuronavigation-guided resection

Sun

Chen

et al. 2015

Childs Nerv Syst

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Cavernous malformations of the central nervous system (CNS) in children: clinico-radiological features and management outcomes of 36 cases

Abstract: Younger children tend to harbor larger CMs and present with hemorrhage more frequently than older ones. Microsurgical resection should be the treatment of choice in symptomatic and accessible CMs.

Cited by 26 publications

References 36 publications

Frontal Lobe Cavernous Malformations in Pediatric Patients: Clinical Features and Surgical Outcomes

Frontal Lobe Cavernous Malformations in Pediatric Patients: Clinical Features and Surgical Outcomes

Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel

Paraventricular or centrum ovale cavernous hemangioma involving the pyramidal tract in children: intraoperative MRI and functional neuronavigation-guided resection

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