N. Acciarri et al., INTRACRANIAL AND ORBITAL CAVERNOUS ANGIOMAS - A REVIEW OF 74 SURGICALCASES, British journal of neurosurgery, 7(5), 1993, pp. 529-539
We present a surgical series of 74 patients (30 males and 44 females)
with pathologically verified cavernous angiomas of the intracranial an
d orbital compartments. Patients were admitted between 1975 and 1991;
six had a family history of cerebral cavernomas, and two had multiple
(two) lesions. The 76 malformations were located as follows: 57 were i
n the cerebral hemispheres, four in the supratentorial ventricles, one
was in the middle cranial fossa, two were in the brain stem, five in
the cerebellum and seven in the orbits. Seizures and focal neurologica
l deficits, and decrease of visual acuity with exophthalmus, were the
main clinical signs observed in patients with intracranial and orbital
cavernomas, respectively. Sixteen patients (21.6%) had a clinically s
ignificant haemorrhage attributable to the cavernous angioma. A number
of these vascular malformations were misdiagnosed by computed tomogra
phy. In the last 10 years magnetic resonance imaging has been the most
sensitive method for detecting these lesions. Seventy-four of the 76
diagnosed cavernomas were treated surgically: a complete excision was
obtained in 68 patients; in two patients with multiple lesions only th
ose causing symptoms were removed. Surgery for the 10 deep lesions was
aided considerably by stereotactic localization. Two patients died in
the immediate postoperative course. The overall outcome was good in 6
6 of the 72 remaining patients, resulting in improved seizure control
or lessened neurological deficit.