Follow-up of 13 patients with surgical treatment of cerebral cavernous malformations: effect on epilepsy and patient disability

Objective: We report a series of 13 patients with surgical treatment of cer ebral cavernous malformation (CM). The aim of this study was to investigate postoperative patient disability and seizure control in patients with CM i n order to clarify indications for neurosurgical removal. In our series we emphasize the beneficial effect of excision of CMs. We also give an overvie w of the current literature covering options for treatment in surgically in accessible CMs. Methods. In this retrospective study we describe the clinic al outcomes of neurosurgical intervention in 13 patients with a CM. Seven p atients had epilepsy at presentation and six had focal neurological deficit s due to intracerebral haemorrhage (five patients) or mass effect due to th e CM (one patient). The modified Rankin scale was used to define patient di sability pre- and postoperatively. An overview of the indications for surge ry and postoperative outcome with follow up periods of 1-6 years (mean: 3.3 years) are provided. Results: In all patients presenting with epilepsy a r eduction in seizure frequency was seen. Four of them became seizure-free po stoperatively. The six patients with neurological deficits due to intracere bral haemorrhage or mass effect due to the CM showed clinical improvement p ostoperatively, two of them made full recoveries. Improvement of the postop erative Rankin score was seen in six of 13 patients. Conclusion: Improvemen t in seizure control and reduction in patient disability warrants surgical intervention in symptomatic CMs. (C) 2001 Elsevier Science B.V. All rights reserved.