SURGICAL-MANAGEMENT OF CAVERNOUS ANGIOMAS IN CHILDREN

Cavernous angiomas are vascular malformations affecting any part of th e central nervous system (CNS). The management of asymptomatic caverno us angiomas is still debated due to their poorly understood natural hi story, although more data are now available regarding results of surgi cal treatment in symptomatic cases. The authors report their surgical experience with 18 pediatric patients operated on for symptomatic CNS cavernous angiomas. The children ranged in age from 10 months to 17 ye ars, without a relevant sex difference. Cavernous angiomas were intrac ranial in 17 cases: 15 being in the supratentorial compartments and tw o in the cerebellum. Clinical manifestations were as follows: seizures in 11 cases, focal neurologic deficits in five, and headache in one. The 18th case was observed in a girl showing paraparesis in the spinal subdural-extramedullary space at T-8-T-9 level. Excision of four deep cerebral lesions was performed after stereotactic localization throug h non-eloquent cortex. Pathologic confirmation of cavernous angiomas w as obtained in all patients. Mortality from surgical procedures was ab sent in this series. The follow-up period ranged from 1 to 16 years. A ll 11 epileptic patients obtained seizure control; improvement or stab ilization of neurologic symptoms was observed in the remaining seven p atients.