Cerebral Cavernous Malformations can be found in approximately 0.5% of the population and in most of the cases are asymptomatic. The diagnosis it’s possible with a MR with T2*, Tl C+ sequences including SWI, but the decision of surgery is often very difficult especially in asymptomatic cases. Removal of accessible lesions is the only direct therapeutic approach for cerebral cavernous malformations (CCMs). A grading scale for the indication of surgery did not exist. We propose a new scale, taking in account several factors: Clinical, neuroradiological and epilectic features. The surgical approach should be carefully evaluated according to a precise assess-ment in order to both select the patient and avoid complications. A quantitative anatomical study and a preoperative simulation of surgery can help to plan the operation. Neuronavigation, ultrasound and neurophysiologic monitoring are generally required respectively to locate the CCMs and to avoid critical areas. In any case before performing surgery the physicians should always consider the benign nature of the lesions and the absolute necessity to avoid not only neurological deficits, but also a neuropsychological impairment that could affect the quality of life.
BRAIN AND SPINAL CORD CAVERNOUS MALFORMATIONS
Fontanella M.Conceptualization
;Zanin L.;Fiorindi A.;Spena G.;Belotti F.;Panciani P.;De Maria L.;Saraceno G.;Cornali C.;Doglietto F.
2020-01-01
Abstract
Cerebral Cavernous Malformations can be found in approximately 0.5% of the population and in most of the cases are asymptomatic. The diagnosis it’s possible with a MR with T2*, Tl C+ sequences including SWI, but the decision of surgery is often very difficult especially in asymptomatic cases. Removal of accessible lesions is the only direct therapeutic approach for cerebral cavernous malformations (CCMs). A grading scale for the indication of surgery did not exist. We propose a new scale, taking in account several factors: Clinical, neuroradiological and epilectic features. The surgical approach should be carefully evaluated according to a precise assess-ment in order to both select the patient and avoid complications. A quantitative anatomical study and a preoperative simulation of surgery can help to plan the operation. Neuronavigation, ultrasound and neurophysiologic monitoring are generally required respectively to locate the CCMs and to avoid critical areas. In any case before performing surgery the physicians should always consider the benign nature of the lesions and the absolute necessity to avoid not only neurological deficits, but also a neuropsychological impairment that could affect the quality of life.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
