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Management of intracranial cavernous malformation in pediatric patients.

 Jae-Whan Lee  ;  Dong-Seok Kim  ;  Kyu-Won Shim  ;  Jong-Hee Chang  ;  Seung-Kon Huh  ;  Yong-Gou Park  ;  Joong-Uhn Choi 
 CHILDS NERVOUS SYSTEM, Vol.24(3) : 321-327, 2008 
Journal Title
Issue Date
Adolescent ; Adult ; Age Factors ; Brain Neoplasms/complications ; Brain Neoplasms/pathology ; Brain Neoplasms/surgery* ; Child ; Child, Preschool ; Female ; Hemangioma, Cavernous, Central Nervous System/complications ; Hemangioma, Cavernous, Central Nervous System/pathology ; Hemangioma, Cavernous, Central Nervous System/surgery* ; Humans ; Infant ; Intracranial Arteriovenous Malformations/complications ; Intracranial Arteriovenous Malformations/pathology ; Intracranial Arteriovenous Malformations/surgery* ; Intracranial Hemorrhages/etiology ; Intracranial Hemorrhages/prevention & control ; Male ; Microsurgery* ; Radiosurgery* ; Treatment Outcome
Cavernous malformation ; Pediatric age ; Hemorrhage ; Seizure ; Microsurgery ; Radiosurgery
OBJECTIVE: Cavernous malformations (CMs) are vascular malformations affecting any part of the central nervous system. CMs in the pediatric age group are known to be different from those of adults both in origin and clinical characteristics. In this paper, we report our experience in managing CMs in pediatric patients.

MATERIALS AND METHODS: Between January 1994 and December 2006, 33 patients younger than 20 years of age with intracranial CMs were treated with microsurgery or radiosurgery. We retrospectively reviewed the presentation and treatment of these 33 patients (18 boys and 15 girls; average age 11.6 years).

RESULTS: The most common symptom at presentation was seizure (19 children, 57.6%). The most common type of CM, classified on the basis of magnetic resonance imaging, was type II (18, 54.5%). The supratentorial compartment was the most frequent location (27, 71.8%), and only six CMs (18.2%) were observed in the infratentorial compartment. Microsurgery was performed on 25 patients (75.8%), and radiosurgery was performed on eight patients (24.2%). The overall post-treatment results were positive. Only two children (6.1%) had persistent presurgical neurological signs, although the treatment ameliorated them. No progression of the preoperative neurological signs or onset of new neurological deficits was seen in any of the patients. In our patient group, the microsurgical removal of CMs resulted in the prevention of recurrent hemorrhage and the control of seizure disorders in all cases.

CONCLUSIONS: Our results suggest that pediatric patients with symptomatic CMs should be treated surgically because of the risk of recurrent hemorrhaging and the general benefits of CM removal.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Seok(김동석)
Park, Yong Gou(박용구)
Shim, Kyu Won(심규원) ORCID logo https://orcid.org/0000-0002-9441-7354
Lee, Jae Whan(이재환)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
Choi, Joong Uhn(최중언)
Huh, Seung Kon(허승곤)
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