1. Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers
- Author
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Edouard Dezamis, Marco Conti Nibali, Marco Rossi, Henry Colle, Costanza Papagno, David Colle, Philip C. De Witt Hamer, Michel Wager, Gilles Huberfeld, Silvio Sarubbo, B. Noens, Philippe Metellus, Christian Schichor, Natan Yusupov, Johan Pallud, Lara Galbarritu, Sandro M. Krieg, Santiago Gil Robles, Peter Barkholt Muller, Franco Chioffi, Marc Zanello, Denys Fontaine, Emmanuel Mandonnet, Juan Martino González, Victoria Visser, Anja Smits, Hans Baaijen, John Goodden, Carlos Bucheli, Megan Still, Laurent Capelle, Hugues Duffau, Lorenzo Bello, Bertil Rydenhag, Nicolas Reyns, Bernhard Meyer, Alexandre Roux, Giannantonio Spena, Erik Robert, Maria Wostrack, Matthew C. Tate, Neurosurgery, VU University medical center, Amsterdam Neuroscience - Systems & Network Neuroscience, Zanello, M, Meyer, B, Still, M, Goodden, J, Colle, H, Schichor, C, Bello, L, Wager, M, Smits, A, Rydenhag, B, Tate, M, Metellus, P, Hamer, P, Spena, G, Capelle, L, Mandonnet, E, Robles, S, Sarubbo, S, Martino Gonzalez, J, Fontaine, D, Reyns, N, Krieg, S, Huberfeld, G, Wostrack, M, Colle, D, Robert, E, Noens, B, Muller, P, Yusupov, N, Rossi, M, Conti Nibali, M, Papagno, C, Visser, V, Baaijen, H, Galbarritu, L, Chioffi, F, Bucheli, C, Roux, A, Dezamis, E, Duffau, H, and Pallud, J
- Subjects
Surgical resection ,Adult ,Male ,medicine.medical_specialty ,Hemangioma, Cavernous, Central Nervous System ,Return to work ,Adolescent ,Eloquent Brain Areas ,Neurosurgical Procedures ,Angioma ,03 medical and health sciences ,Epilepsy ,Young Adult ,0302 clinical medicine ,Seizures ,Surveys and Questionnaires ,medicine ,Humans ,Prospective cohort study ,Child ,Outcome ,Aged ,Brain Mapping ,Intra-operative brain mapping ,business.industry ,Brain Neoplasms ,General surgery ,International survey ,Cavernous angioma ,Brain ,Infant ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Hemangioma, Cavernous ,Treatment Outcome ,Neurology ,Hemosiderin ,Child, Preschool ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Purpose The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area. Method An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area. Results 272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control. Conclusions We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection.
- Published
- 2019
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