Seizure outcome after resection of supratentorial cavernous malformations: A study of 168 patients
Seizure outcome after resection of supratentorial cavernous malformations: A study of 168 patients
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DOI：
10.1111/j.1528-1167.2006.00941.x
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发表时间：
2007-03-01
期刊：
影响因子：
5.6
通讯作者：
Siegel, Adrian M.
中科院分区：
文献类型：
--
作者：
Baumann, Christian R.;Acciarri, Nicola;Siegel, Adrian M.
目的：脑海绵状畸形（CCM）伴癫痫发作的最佳治疗仍然是一个有争议的问题。我们的研究的目的是检查癫痫发作的结果在最大的一系列发表的手术治疗癫痫患者由于幕上CCM，并确定良好的手术outcome.Methods预测：我们回顾性研究了168例连续与一个单一的幕上CCM和症状性癫痫的多中心研究。评估术前和术后临床检查、癫痫发作时的年龄、手术时的年龄、CCM引起的症状类型（癫痫发作、头痛、出血、局灶性缺陷）、癫痫发作的类型和频率以及CCM的位置和大小。癫痫发作的结果是在第一，第二，第三术后years.Results：CCM完全切除所有患者。超过三分之二的患者在术后的前3年内被归类为无癫痫发作。良好癫痫预后的预测因素为手术时年龄大于30岁、近中颞侧CCM定位、CCM大小< 1.5 cm和无继发全身性癫痫发作。没有死亡发生在我们的系列，但只有轻微的术后神经功能缺损12（7%）patients.Conclusions：考虑到CCM的自然史，良好的神经和癫痫发作的结果，手术切除CCM应考虑在所有患者幕上CCM和伴随癫痫，无论是否存在一个良好的癫痫发作的结果的预测因素。
Purpose: The optimal management of cerebral cavernous malformations (CCMs) with epileptic seizures is still a matter of debate. The aim of our study was to examine seizure outcome in the largest published series of surgically treated patients with epilepsy due to a supratentorial CCM, and to define predictors for good surgical outcome.Methods: We retrospectively studied 168 consecutive patients with a single supratentorial CCM and symptomatic epilepsy in a multicenter study. Pre- and postoperative clinical examinations, age at epilepsy onset, age at operation, type of symptoms due to the CCM (seizures, headache, hemorrhage, focal deficits), type and frequency of epileptic seizures, and the localization and size of the CCM were assessed. Seizure outcome was determined in the first, second, and third postoperative years.Results: The CCM was completely resected in all patients. More than two thirds of the patients were classified as seizure free in the first 3 postoperative years. Predictors for good seizure outcome were age older than 30 years at the time of surgery, mesiotemporal CCM localization, CCM size < 1.5 cm, and the absence of secondarily generalized seizures. No mortality occurred in our series, but only mild postoperative neurologic deficits in 12 (7%) patients.Conclusions: Considering the natural history of CCMs, the favorable neurologic and seizure outcome, surgical resection of CCMs should be considered in all patients with supratentorial CCMs and concomitant epilepsy, irrespective of the presence or absence of predictors for a favorable seizure outcome.