[Surgical treatment of cortical and subcortical cavernomas. General principles and personal series of 20 cases treated between 2000 and 2006]

S Khouri, P Lacerda Leal, J Guarnieri, A Borha, B Gadan, E Emery, J-M Derlon
Neuro-Chirurgie 2007, 53 (2): 163-7
The surgical treatment of cortical or subcortical hemispheric cavernomas is founded on a series of questions: Is the cavernoma located in an eloquent or non-eloquent area? Is the cavernoma tangent to the cortex and visible immediately after the dura opening or deep seated in the hemisphere? Does the cavernoma lie in the depth of a sulcus and identifiable on the pretrans-sulcal approach MRI? Will perilesional tissue have to be removed to cure the epilepsy? What is the appropriate technology for each particular case: preoperative functional MRI, angiography, preoperative stereotactic guidance, peroperative ultrasonography, neuronavigation, peroperative neurophysiology and cortical stimulation, preoperative MRI? Based on a personal series of 20 cases operated on between 2000 and 2006, we describe our personal experience.

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