Treatment of Brainstem Cavernomas.
- Author:
Sang Bok LEE
1
;
Jung Il LEE
;
Jong Soo KIM
;
Seung Chyul HONG
;
Kwan PARK
Author Information
1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. byungp@wonnms.wonkwang.ac.kr
- Publication Type:Original Article
- Keywords:
Cavernous angioma;
Brainstem;
Microsurgery;
Radiosurgery
- MeSH:
Brain Stem*;
Follow-Up Studies;
Hemangioma, Cavernous;
Humans;
Microsurgery;
Neuroimaging;
Postoperative Period;
Radiosurgery;
Retrospective Studies
- From:Korean Journal of Cerebrovascular Surgery
2004;6(1):58-63
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE:The goal of this study is to evaluate the clinical outcome of the patients with brainstem cavernous angiomas after treatment with microsurgery or radiosurgery. METHODS:Fifteen patients with brainstem cavernous angiomas were treated at the authors' institution between 1995 and 2003. Clinical record and neuroimaging examinations were retrospectively reviewed. RESULTS: Ten patients underwent microsurgical resection. Radical excision was achieved in all of them. In 6 patients (60%), transitory neurological deterioration or new neurological deficit after immediate postoperative period. The final outcomes at 6-70 months after surgery were improved in 8 patients (80%) and unchanged in 2 (20%) compared with preoperative state. Radiosurgery was performed as an initial treatment in 6 patients. During the follow up period from 5 to 60 months there was neurological improvement in 3 patients and no significant change in 2. One patient developed rebleeding at 60 months after radiosurgery and underwent microsurgical resection. CONCLUSION:Symptomatic cavernous angioma of brainstem can be treated with microsurgical resection with acceptable morbidity. Radiosurgery is an effective alternative for the lesion which is not accessible by surgical approach, however, still there is possibility of rebleeding over long period after radiosurgical treatment. Fatal complication is rare with appropriate surgical approach in well selected patient. Microsurgery should be considered as a treatment with priority for the majority of cases.
