Surgical management of brain cavernomas in children

George A Alexiou, Evriviadis Mpairamidis, George Sfakianos, Neofytos Prodromou
Pediatric Neurosurgery 2009, 45 (5): 375-8

BACKGROUND: Cavernous hemangiomas are benign vascular hamartomas caused by developmental malformations of the vascular bed. They can be found in 0.3-0.7% of the population, whereas one fourth of these lesions occur in children.

METHODS: In the present study, we report on 16 cases of cavernomas surgically treated in our institute. From each patient's file, the age, sex, lesion location, symptoms and follow-up were analyzed.

RESULTS: The most commonly presenting symptom was epilepsy. Radiological signs of acute hemorrhage were observed in 3 cases. Three children had multiple cavernomas. The parietal lobe was the most common site of occurrence, whereas only 2 cavernomas were infratentorial. There was no operative mortality. Postoperatively, there was no additional neurological deficit, and all patients gradually improved. In a case of pontine cavernoma, there was a need for reoperation due to rebleeding.

CONCLUSION: With the improvement of microsurgical techniques and modern neuroimaging, nearly all cavernomas can be safely removed. Total resection is associated with patients' clinical improvement and seizure control.

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