Intracranial cavernous malformation in children: a single-centered experience with 30 consecutive cases

Amato, Marcelo Campos Moraes; Madureira, João Flávio Gurjão; Oliveira, Ricardo Santos de

doi:10.1590/0004-282x20130006

Cited by 28 publications

(22 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These malformations are typically described in adult patients, either in surgical 22,36,39,49 or observational studies, 33 or with supratentorial CMs; 4,6,14,17,18,23,45,46 however, CMs are seldom described as a separate cohort. In the present study, we demonstrated that all patients benefited from surgery and were either improved or unchanged after a mean follow-up of 7.9 years.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical management of pediatric brainstem cavernous malformations

Li¹,

Hao²,

Tang³

et al. 2014

PED

View full text Add to dashboard Cite

Object The goal of this study was to evaluate surgical outcomes of pediatric brainstem cavernous malformations (CMs) and identify the risk factors associated with postoperative full recovery and rebleeding. Methods The clinical charts and radiographs from a series of 52 pediatric patients (37 male and 15 female; mean age 12.2 years; range 1–17 years) who underwent surgery for brainstem CMs between 1996 and 2011 were reviewed. Follow-up evaluation measures were obtained retrospectively. Neurological function was evaluated using the modified Rankin Scale (mRS) score. Results The lesion locations among the 52 patients included the midbrain (n = 7, 13.5%), pons (n = 38, 73.1%), and medulla (n = 7, 13.5%). The mean duration of symptoms was 18.5 months, and the preoperative annual hemorrhage and rebleeding rates were 12.3% and 32.5% per patient-year, respectively. The mean lesion size was 2.1 cm. Gross-total resection without surgery-related death was achieved in 49 patients (94.2%). Immediate postoperative reduced neurological function was observed in 17 patients (32.7%). Surgical morbidities developed in 25 patients (48.1%) and remained in 11 patients (21.2%) after 7.9 years of follow-up. The mean mRS scores at admission, discharge after surgery, 3 and 6 months postsurgery, and recent evaluation were 2.0, 2.3, 2.0, 1.5, and 1.0, respectively. The postoperative mRS scores at 6 months (p < 0.001) and on recent evaluation (p < 0.001) were significantly lower than those at admission. Postoperative rebleeding occurred in 2 patients, and the postoperative annual rebleeding rate was 0.5% per patient-year. By the most recent evaluation, 10 patients (19.2%) had achieved full recovery and all patients were either improved (n = 32, 61.5%) or unchanged (n = 20, 38.5%). The adverse predictors for full recovery included age ≥ 12 years (HR 0.230, p = 0.021), ≥ 2 preoperative hemorrhages (HR 0.124, p = 0.048), and poor preoperative status (HR 0.197, p = 0.040). An HR < 1 predicted poor complete recoveries. The single risk factor predicting postoperative rebleeding was incomplete resection (χ2 = 4.340, p = 0.037). Conclusions Fair outcomes for pediatric brainstem CMs could be obtained through surgery, but only a few patients achieved full recovery. Thus, to minimize surgical morbidity, surgical planning must be tailored to individual patients in all cases in which an operation is warranted. Complete resection must be attempted to reduce the risk of postoperative rebleeding. The predictors associated with complete postoperative recovery were referential for determining treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Comparing outcomes in brainstem CMs and their supratentorial counterparts was nonsensical, although the supratentorial counterparts have been associated with extraordinarily favorable prognoses. 4,6,18,28,46 Nonetheless, surgery was warranted in carefully selected patients with brainstem CMs. Di Rocco et al…”

Section: Functional Outcomementioning

confidence: 99%

Surgical management of pediatric brainstem cavernous malformations

Li¹,

Hao²,

Tang³

et al. 2014

PED

View full text Add to dashboard Cite

show abstract

“…18,20,26 Surgical removal of symptomatic CCM is considered the treatment of choice with a good overall outcome. 2,5,[9][10][11]16,19,24 All patients in our series also underwent excision of the CCM and associated hematomas with an excellent overall clinical outcome. Considering their location, CCMs are straightforward to access surgically.…”

Section: Treatment Options and Outcomementioning

confidence: 89%

“…Cerebellar CMs differ from supratentorial CMs that present most often with seizures 2,5,23,24,27,39 and from brainstem CMs, which become obvious with focal neurological deficits.…”

Section: Clinical Presentationmentioning

confidence: 99%

Cerebellar cavernous malformation in pediatric patients: defining clinical, neuroimaging, and therapeutic characteristics

Knerlich-Lukoschus

Steinbok

Dunham

et al. 2015

PED

View full text Add to dashboard Cite

OBJECT Cerebellar cavernous malformations (CCMs) have not been specifically described in the pediatric age group. Authors of this study, after considering the published literature, describe the characteristic clinical, radiological, and surgical features of CCM in children. METHOSDS Patients younger than 18 years of age who were known to have CCM and had undergone surgery between 1992 and 2014 at the authors’ institution were reviewed. Pediatric CCM cases reported in the literature (case reports and cases included in series on CMs in the pediatric age group) were also analyzed for specific features of this entity. RESULTS Four male patients and 1 female patient (2.5–14 years of age) with CCM presented acutely with severe headache followed by cerebellar dysfunction. In all patients, neuroimaging (cranial CT and MRI) demonstrated hemorrhagic cerebellar lesions with heterogeneous T1 and T2 signal intensities and hyperintense blooming on susceptibility-weighted imaging. The lesions reached large sizes exhibiting spherical, cystic, and often “pseudotumoral” morphology. In 3 patients, developmental venous anomalies (DVAs) were found. In 4 of the 5 patients, the CCMs and hematomas were totally removed. All patients had a clinically excellent functional outcome without surgical complication and with complete resolution of their presenting symptoms. CONCLUSIONS Cerebellar CMs occur in all pediatric age groups and display characteristic clinical and imaging features. In children, CCMs reach large sizes and can result in massive hemorrhage, often leading to a possible diagnosis of hemorrhage into a tumor. An associated DVA is quite common. Surgery is a safe and efficient treatment option with excellent outcomes in patients.

show abstract

“…CNS neoplasm can be classified in various ways depending upon location (topographical i.e. supratentorial or infratentorial), [5] extra or intra-axial. Further classification is based on histological characteristics.…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography Evaluation of Supratentorial Brain Tumours

Preethi¹,

Mariappan²

2017

Ann. Int. Med. Den. Res.

View full text Add to dashboard Cite

Background: Imaging modalities like CT and MRI may play a vital role in diagnostic evaluation of CNS neoplasms.But the relative superiority of these modalities is intensely debated in the literature. Computed tomography, with it's wider availability, lesser cost and higher efficacy in differentiating calcification/ hemorrhage which can play a vital role in resourcepoor settings. Methods: The current study was a prospective observational study of 50 patients with supratentorial brain tumours reporting to radiology department for CT brain, in a tertiary care teaching hospital in south India. Results: Glioma (48%) was the most common tumour.Pilocyticastrocytomas and low-grade Glioma were seen in younger and middle-age population (<45 years), whereas Anaplastic astrocytoma, GBM and Oligodendroglioma showed incidence after 45 years of age.CT accurately characterized 42 of the total 50 cases. Diagnostic accuracy of CT in characterizing Meningioma, Pilocytic astrocytoma, Craniopharyngioma, Oligodendroglioma and pituitary adenomas was better than anaplastic astrocytoma and glioblastoma multiforme. Glioma mostly presented as hypo-dense lesion in NCCT while majority of Meningioma were hyper dense.Necrosis was seen in metastasis and GBM. Calcifications were seen in meningioma, craniopharyngioma and oligodendroglioma Conclusion: Supratentorial tumours can be seen in pediatric age group as well as in adults and elderly population. Glioma was the most common supratentorial brain tumour followed by meningioma and metastases. CT features are fairly characteristic in meningioma, craniopharyngioma and pituitary adenoma with overlap of imaging features in anaplastic astrocytoma, GBM and solitary metastasis.

show abstract

Intracranial cavernous malformation in children: a single-centered experience with 30 consecutive cases

Cited by 28 publications

References 25 publications

Surgical management of pediatric brainstem cavernous malformations

Surgical management of pediatric brainstem cavernous malformations

Cerebellar cavernous malformation in pediatric patients: defining clinical, neuroimaging, and therapeutic characteristics

Computed Tomography Evaluation of Supratentorial Brain Tumours

Contact Info

Product

Resources

About