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Results of Surgery for Cavernomas in Critical Supratentorial Areas

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Book cover Trends in Neurovascular Interventions

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 119))

Abstract

A total of 121 patients surgically treated between 1991 and 2011 for cavernomas in critical supratentorial areas were evaluated. Anatomical location, size and the possible association with developmental venous anomalies (DVA) were assessed in each case: 43 cavernomas were in the speech area, 39 were rolandic (or peri-rolandic), 14 insular, 10 nuclear, 9 calcarine and 6 ventricular. In 49 % of the cases, the cavernoma was <1.5 cm; in 6 patients, radiological growth was documented. A method of intraoperative localization was adopted in 78 cases: B-mode echography or a stereotactic guide in 22 cases, and a neuronavigation system in 56 cases; preoperative angiography was done in 22 cases. Early postoperative epilepsy (within 7 days of surgery) was observed in 15 cases. As for clinical outcome, 14 patients presented with mild symptoms (modified Rankin Scale 1–2); significant deficits occurred ex-novo in 5 patients. The presence of epilepsy at follow-up was assessed through the Maraire Scale: 44 % of patients presenting with epilepsy were free of seizures and without therapy at a mean follow-up of 4.6 years, and an additional 55 % had complete control of seizures with therapy. It is concluded that surgery is indicated in the management of cavernomas in critical supratentorial locations, with a caveat for insula and especially basal ganglia.

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Conflict of Interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Section of Vascular Neurosurgery, Institute of Neurosurgery, Verona City Hospital, Via Milazzo, 2, Verona, 37128, Italy

    A. Pasqualin, P. Meneghelli & A. Giammarusti

  2. Institute of Neurosurgery, Verona City Hospital, Via Milazzo, 2, Verona, 37128, Italy

    S. Turazzi

Authors
  1. A. Pasqualin
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  2. P. Meneghelli
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  3. A. Giammarusti
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  4. S. Turazzi
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Corresponding author

Correspondence to A. Pasqualin .

Editor information

Editors and Affiliations

  1. Dept. of Neurosurgery, Kyoto Medical Center, Kyoto, Japan

    Tetsuya Tsukahara

  2. Klinik für Neurochirurgie UniversitätsSpital Zürich, Zürich, Switzerland

    Giuseppe Esposito

  3. Neurochirurgische Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany

    Hans-Jakob Steiger

  4. Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands

    Gabriel J.E. Rinkel

  5. Klinik für Neurochirurgie UniversitätsSpital Zürich, Zürich, Switzerland

    Luca Regli

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Pasqualin, A., Meneghelli, P., Giammarusti, A., Turazzi, S. (2014). Results of Surgery for Cavernomas in Critical Supratentorial Areas. In: Tsukahara, T., Esposito, G., Steiger, HJ., Rinkel, G., Regli, L. (eds) Trends in Neurovascular Interventions. Acta Neurochirurgica Supplement, vol 119. Springer, Cham. https://doi.org/10.1007/978-3-319-02411-0_20

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  • DOI: https://doi.org/10.1007/978-3-319-02411-0_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-02410-3

  • Online ISBN: 978-3-319-02411-0

  • eBook Packages: MedicineMedicine (R0)

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