Abstract
We retrospectively reviewed the clinical experience of 30 patients with brain stem cavernous malformations (BSCM) treated operatively and non-operatively at our hospital between 1983 and 2005 to elucidate the natural history of BSCM and the factors that affect surgical outcome. Inpatient charts, imaging studies, operative records, and follow-up results were evaluated. The average follow up was 48.5 months. Twenty-two patients (73.3%) received surgical extirpation and of these 86.4% improved or stabilized and 13.6% deteriorated with permanent or severe morbidity. There was no mortality. Size, preoperative status, and surgical timing were factors related to surgical outcome. In the non-operative group, 50% of the patients were the same or better, 25% deteriorated, and 25% died. With appropriate patient selection, resection of BSCM can be achieved with acceptable morbidity compared with the ominous natural history of these lesions.
Copyright (c) 2009 Elsevier Ltd. All rights reserved.
MeSH terms
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Adolescent
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Adult
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Aged
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Brain Stem / pathology*
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Brain Stem / physiopathology
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Brain Stem / surgery*
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Brain Stem Infarctions / etiology
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Brain Stem Infarctions / physiopathology
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Brain Stem Infarctions / prevention & control
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Brain Stem Neoplasms / pathology*
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Brain Stem Neoplasms / physiopathology
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Brain Stem Neoplasms / surgery*
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Cerebral Arteries / abnormalities
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Cerebral Arteries / pathology
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Cerebral Arteries / surgery
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Cerebral Veins / abnormalities
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Cerebral Veins / pathology
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Cerebral Veins / surgery
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Child
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Female
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Hemangioma, Cavernous, Central Nervous System / pathology*
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Hemangioma, Cavernous, Central Nervous System / physiopathology
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Hemangioma, Cavernous, Central Nervous System / surgery*
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Humans
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Intracranial Hemorrhages / etiology
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Intracranial Hemorrhages / physiopathology
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Intracranial Hemorrhages / prevention & control
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Male
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Middle Aged
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Neoplasm Recurrence, Local / epidemiology
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Neoplasm Recurrence, Local / prevention & control
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Neurosurgical Procedures / methods
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Neurosurgical Procedures / statistics & numerical data
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Outcome Assessment, Health Care
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Postoperative Hemorrhage / epidemiology
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Postoperative Hemorrhage / prevention & control
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Retrospective Studies
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Treatment Outcome
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Young Adult