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Titolo:
Surgical management of brainstem cavernomas
Autore:
Samii, M; Eghbal, R; Carvalho, GA; Matthies, C;
Indirizzi:
Krankenhaus Nordstadt, Neurochirurg Klin, Dept Neurosurg, D-30167 Hannover, Germany Krankenhaus Nordstadt Hannover Germany D-30167 D-30167 Hannover, Germany Univ Hannover, Sch Med, Dept Neurosurg, Hannover, Germany Univ Hannover Hannover Germany h Med, Dept Neurosurg, Hannover, Germany
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 5, volume: 95, anno: 2001,
pagine: 825 - 832
SICI:
0022-3085(200111)95:5<825:SMOBC>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
NATURAL-HISTORY; VASCULAR MALFORMATIONS; STEM; ANGIOMAS; APPEARANCE; SURGERY; RESECTION; REMOVAL;
Keywords:
brainstem; cavernous angioma; pons; vascular malformation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Carvalho, GA Krankenhaus Nordstadt, Neurochirurg Klin, Dept Neurosurg, Haltenhoffstr 41, D-30167 Hannover, Germany Krankenhaus Nordstadt Haltenhoffstr 41 Hannover Germany D-30167
Citazione:
M. Samii et al., "Surgical management of brainstem cavernomas", J NEUROSURG, 95(5), 2001, pp. 825-832

Abstract

Object. A careful retrospective analysis of 36 cases was pet-formed to evaluate the pre- and postoperative rates of morbidity that occur in patients with brainstem cavernous angiomas. Methods. The authors evaluated immediate postoperative and follow-up outcomes with regard to clinical findings, the incidence of preoperative hemorrhage(s), location and size of the lesions, and the timing of the surgical procedure after the last hemorrhagic event. Specifically, the following parameters were analyzed: 1) number of hemorrhages; 2) the precise brainstem location (pontomesencephalic, pons, and medulla oblongata); 3) pre- and postoperative cranial nerve status 4) pre- and postoperative motor and sensory deficits; 5) size (volume) of the lesions; and 6) pre- and postoperative Karnofsky Performance Scale (KPS) scores. Multiple hemorrhages were observed in16 patients, particularly in those with pontomesencephalic cavernous angiomas (75%). The mean preoperative KPS score was 70.3 +/- 16.3 (+/- standard deviation). Twenty-six patients (72.2%) presented with cranial nerve impairment, 13 (36.1%) with motor deficits, and 17 (47.2%) with sensory disturbance. Volume of the lesions ran-ed from 0.18 to 18.18 cm(3) (mean 4.75 cm(3)). Postoperative complications included new cranial nerve deficits in 17 patients, motor deficits in three, and new sensory disturbances in 12 patients. In a mean follow-up period of 21.5 months, KPS scores were 80 to 100 in 22 patients. Timing of surgery (posthemorrhage) and multiple hemorrhages didnot influence the long-term results. Higher preoperative KPS scores and smaller-volume lesions, however, were factors associated with a better final outcome (p < 0.05). Major morbidity was related mainly to preoperative status and less to surgical treatment. The incidence of new postoperative cranial nerve deficits was clearly lower than that demonstrated preoperatively because of the brainstem hemorrhages. Conclusions. Based on these findings, resection of brainstem cavernomas isthe treatment of choice in the majority of these cases because of the highincidence of morbidity related to one or often several brainstem hemorrhages.

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Documento generato il 01/12/20 alle ore 01:09:55