Artikel
Posterior fossa cavernous malformations: A surgical series of 35 patients
Kavernöse Malformationen der hinteren Schädelgrube: Eine Serie von 35 operierten Patienten
Suche in Medline nach
Autoren
Veröffentlicht: | 30. Mai 2008 |
---|
Gliederung
Text
Objective: Cavernous malformations (CMs) are not seldom located in the posterior fossa. We therefore aimed to analyze our patients operated on a posterior fossa CM with respect to the functional results and in order to analyze factors with impact on clinical outcome.
Methods: Between January 1990 and August 2007 35 consecutive patients with a CM of the posterior fossa underwent microneurosurgical resection in our institution. Age ranged from 11 to 62 years (mean 36.1 years). Most patients become symptomatic due to one or repetitive hemorrhages. The patient’s pre- and postoperative condition was classified according to the Frankel scale.
Results: In 21 patients the CM was located in the brainstem, in 11 patients in the cerebellar hemisphere and in 3 patients in the cerebellar peduncle. Most patients were operated via a suboccipital craniotomy in a semisitting position.
The postoperative condition was improved or unchanged in 31 patients and worse in 3 patients. One patient died due to a severe cerebellar hemorrhagic infarction. Brainstem lesions were found to have an increased risk of repetitive hemorrhages.
Conclusions: Acute onset of symptoms with subsequent neurological deterioration was the result of one or repetitive hemorrhages in symptomatic patients. Based on the increased risk of rehemorrhage and the gratifying functional results, surgery is indicated for symptomatic CMs. However, venous anomalies should remain intact in order to avoid a fatal outcome, especially in CMs of the posterior fossa.