cal management of cerebral cavernous angiomas causing epilepsy. Journal of ... angioma: a study of 52 families from International Familial. Cavernous ...
Epilepsia, 48(3):559–563, 2007 Blackwell Publishing, Inc. C 2007 International League Against Epilepsy
Seizure Outcome after Resection of Supratentorial Cavernous Malformations: A Study of 168 Patients ∗ Christian R. Baumann, †Nicola Acciarri, ‡Helmut Bertalanffy, §Orrin Devinsky, Christian E. Elger, ¶Giorgio Lo Russo, ¶Massimo Cossu, ‡Uli Sure, §Anuradha Singh, ∗∗ Hermann Stefan, ∗∗ Tilo Hammen, ∗ Dimitrios Georgiadis, ∗ Ralf W. Baumgartner, ††Frederick Andermann, and ∗ Adrian M. Siegel ∗ Department of Neurology, University Hospital, Zurich, Switzerland; †Department of Neurosurgery, Bellaria Hospital, Bologna, Italy; ‡Department of Neurosurgery, Philipps University Hospital, Marburg, Germany; §Department of Neurology, New York University School of Medicine, New York, New York, U.S.A.; Klinik fur Epileptologie, Universitatsklinik Bonn, Bonn, Germany; ¶ Epilepsy Surgery Centre “C. Munari,” Ospedale Niguarda, Milan, Italy; ∗∗ Epilepsy Centre, Neurological Clinic, University Erlangen-Nuernberg, Erlangen, Germany; and ††Epilepsy Clinic, Montreal Neurological Hospital and Institute, Montreal, Quebec, Canada
Summary: 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
