OBJECTIVE: The optimal management of seizures associated with cerebral cavernous malformations (CCMs) is unclear. The aim of this study was to determine the efficacy of surgery in the management of CCM-associated seizures. METHODS: We conducted a retrospective review with follow-up of 164 patients who underwent microsurgical resection of supratentorial CCMs. Clinical and radiographic data were collected and then analyzed to determine predictors of developing epilepsy and predictors of postoperative seizure control after microsurgical resection. RESULTS: Of the patients, 61.5% presented with seizures, and 34.7% had clinically defined epilepsy. The development of epilepsy was associated with CCMs located in the temporal lobe and the absence of symptomatic hemorrhage. After microsurgical resection in 44 patients with intractable epilepsy, 72.7% were completely seizure-free (Engel class 1), 11.4% had rare seizures (Engel class 2), 4.5% had meaningful improvement (Engel class 3), and 11.4% had no improvement (Engel class 4). Predictors of complete seizure freedom were gross total resection, smaller CCMs, and the absence of secondary generalized seizures (94% of patients were seizure-free with all 3 predictors). CONCLUSION: Surgery is a safe and effective treatment for seizures associated with CCMs.
OBJECTIVE: The optimal management of seizures associated with cerebral cavernous malformations (CCMs) is unclear. The aim of this study was to determine the efficacy of surgery in the management of CCM-associated seizures. METHODS: We conducted a retrospective review with follow-up of 164 patients who underwent microsurgical resection of supratentorial CCMs. Clinical and radiographic data were collected and then analyzed to determine predictors of developing epilepsy and predictors of postoperative seizure control after microsurgical resection. RESULTS: Of the patients, 61.5% presented with seizures, and 34.7% had clinically defined epilepsy. The development of epilepsy was associated with CCMs located in the temporal lobe and the absence of symptomatic hemorrhage. After microsurgical resection in 44 patients with intractable epilepsy, 72.7% were completely seizure-free (Engel class 1), 11.4% had rare seizures (Engel class 2), 4.5% had meaningful improvement (Engel class 3), and 11.4% had no improvement (Engel class 4). Predictors of complete seizure freedom were gross total resection, smaller CCMs, and the absence of secondary generalized seizures (94% of patients were seizure-free with all 3 predictors). CONCLUSION: Surgery is a safe and effective treatment for seizures associated with CCMs.
Authors: Siobhan West; Sarah J Nevitt; Jennifer Cotton; Sacha Gandhi; Jennifer Weston; Ajay Sudan; Roberto Ramirez; Richard Newton Journal: Cochrane Database Syst Rev Date: 2019-06-25
Authors: Syed Ali Ahsan; Kassem Chendeb; Robert G Briggs; Luke R Fletcher; Ryan G Jones; Arpan R Chakraborty; Cameron E Nix; Christina C Jacobs; Alison M Lack; Daniel T Griffin; Charles Teo; Michael Edward Sughrue Journal: J Neurooncol Date: 2020-01-01 Impact factor: 4.130
Authors: Lucas Crociati Meguins; Rodrigo Antônio Rocha da Cruz Adry; Sebastião Carlos da Silva Júnior; Carlos Umberto Pereira; Jean Gonçalves de Oliveira; Dionei Freitas de Morais; Gerardo Maria de Araújo Filho; Lúcia Helena Neves Marques Journal: Surg Neurol Int Date: 2015-11-16