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Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers.

Journal article
Authors Marc Zanello
Bernhard Meyer
Megan Still
John R Goodden
Henry Colle
Christian Schichor
Lorenzo Bello
Michel Wager
Anja Smits
Bertil Rydenhag
Matthew Tate
Philippe Metellus
Philip De Witt Hamer
Giannantonio Spena
Laurent Capelle
Emmanuel Mandonnet
Santiago Gil Robles
Silvio Sarubbo
Juan Martino González
Denys Fontaine
Nicolas Reyns
Sandro M Krieg
Gilles Huberfeld
Maria Wostrack
David Colle
Erik Robert
Bonny Noens
Peter Muller
Natan Yusupov
Marco Rossi
Marco Conti Nibali
Costanza Papagno
Victoria Visser
Hans Baaijen
Lara Galbarritu
Franco Chioffi
Carlos Bucheli
Alexandre Roux
Edouard Dezamis
Hugues Duffau
Johan Pallud
Published in Seizure
Volume 69
Pages 31-40
ISSN 1532-2688
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 31-40
Language en
Links dx.doi.org/10.1016/j.seizure.2019.0...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Clinical Medicine

Abstract

The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area.An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area.272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control.We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection.

Page Manager: Webmaster|Last update: 9/11/2012
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