Cavernous angiomas of the supratentorial compartment.

In a retrospective study the clinical data of ten consecutive patients with a cavernous angioma (cavernoma) confined to the supratentorial compartment are presented. The lesions were almost equally distributed among the cerebral cortex with three cavernomas each in the parietal and temporal region and two lesions each being located in the frontal and occipital lobes. The predominant clinical symptoms were either focal or generalized seizures which occurred in 8 patients. One patient became symptomatic due to an intracerebral bleeding from the cavernous angioma, one patient developed a visual field defect from an occipitally localized cavernoma. In 7 patients the neurological status on admission was normal, two patients had signs of a slowly progressing psychosyndroma, one patient had a homonymous hemianopia. The time interval from onset of symptoms to final diagnosis showed a considerable variability ranging from one months to 33 years. Only in half of the patients this interval was less than 6 months. CT-scan was the most important radiological procedure for the diagnosis of these malformations, while MRI may be even more sensible in detecting these lesions in the future. The treatment of choice for these tumorous vascular malformations is microneurosurgical extirpation. This can be accomplished with neglectible morbidity leading to a significant decrease of the preoperative incidence and severity of epileptic seizures.