CAVERNOUS HEMANGIOMAS - INDICATIONS FOR O PERATIVE REMOVAL AND RESULTS

Between July 1990 and October 1994 26 patients were operated on for 26 intracranial and 2 intraorbital cavernous hemangiomas. We found seizu res in 62 % of our patients, focal neurological deficits and unspecifi c complains (like headache or dizziness) in 19% each. The average foll ow-up period was 12 months, 24 patients could be included in this stud y. 12/14 patients of the seizure group improved, 10/14 reported a comp lete relieve of their epilepsy. All 5 patients with focal deficits imp roved, among them 2 with no residual deficit. Finally 3/5 patients wit h unspecific complains improved, 2/5 remained unchanged. The functiona l morbidity was 4% (one slight aphasic syndrom), we did not have any m ortality. Therefore we conclud that a neurosurgical treatment is indic ated in any case of cavernous hemangioma with focal deficits or intrac table epilepsy. The operation should also be considered in patients wi th supressed seizures by anticonvulsants, if the malformation is not l ocated in an eloquent area. Due to the risk of spontaneous bleeding (c omparable to incidental aneurysms), the indication for a neurosurgical treatment mainly depends on the location of the cavernoma in cases of its accidental discovery.