Abstract:
BACKGROUND:Cerebral cavernous malformation (CCM) is frequently associated with intractable focal epilepsy. Epileptogenicity is usually attributed to the hemosiderin deposits. Extent of resection is a crucial issue for achieving good seizure outcome. AIM:To assess whether seizure outcome is related to the extended resection (ER) of surrounding hemosiderin fringe brain tissue. MATERIALS AND METHODS:Between April 2000 and April 2008, 132 patients with CCM and refractory epilepsy were scheduled for surgery based on the high-resolution magnetic resonance imaging (MRI) findings and intensive video-electroencephalogram (EEG) monitoring. All patients underwent pre- and post-operative MRI. Based on MRI findings patients were grouped into: ER group (ER, hemosiderin completely removed) and lesionectomy group (LE, hemosiderin not/partially removed). Post-operative seizure outcome was compared between the two groups based on Engel and the International League Against Epilepsy outcome scales. RESULTS:At 1-year follow-up of the 86 patients in the ER group, 54 (74.4%) achieved seizure free outcome and in the LE group of the 46 patients, 20 (59.5%) achieved seizure-free outcome. At 5-year follow-up, 59.5% (25/42) of patients in ER group and 27.8% (5/18) of patients in LE group achieved seizure-free outcome. ER was not associated with increased neurological morbidity. CONCLUSIONS:Our study suggests that complete removal of hemosiderin fringe brain tissue surrounding CCMs may improve short-term and long-term seizure outcome.
journal_name
Neurol Indiajournal_title
Neurology Indiaauthors
Wang X,Tao Z,You C,Li Q,Liu Ydoi
10.4103/0028-3886.115070subject
Has Abstractpub_date
2013-05-01 00:00:00pages
288-92issue
3eissn
0028-3886issn
1998-4022pii
ni_2013_61_3_288_115070journal_volume
61pub_type
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