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1. Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers

Author

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, Pallud, J, Zanello M., Meyer B., Still M., Goodden J. R., Colle H., Schichor C., Bello L., Wager M., Smits A., Rydenhag B., Tate M., Metellus P., Hamer P. D. W., Spena G., Capelle L., Mandonnet E., Robles S. G., Sarubbo S., Martino Gonzalez J., Fontaine D., Reyns N., Krieg S. M., 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., Pallud J., 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, Pallud, J, Zanello M., Meyer B., Still M., Goodden J. R., Colle H., Schichor C., Bello L., Wager M., Smits A., Rydenhag B., Tate M., Metellus P., Hamer P. D. W., Spena G., Capelle L., Mandonnet E., Robles S. G., Sarubbo S., Martino Gonzalez J., Fontaine D., Reyns N., Krieg S. M., 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.

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

2. Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

Author

Zanello, M, Goodden, J, Colle, H, Wager, M, Hamer, P, Smits, A, Bello, L, Tate, M, Spena, G, Bresson, D, Capelle, L, Robles, S, Sarubbo, S, Rydenhag, B, Martino, J, Meyer, B, Fontaine, D, Reyns, N, Schichor, C, Metellus, P, Colle, D, Robert, E, Noens, B, Muller, P, Rossi, M, Nibali, M, Papagno, C, Galbarritu, L, De Gopegui, E, Chioffi, F, Bucheli, C, Krieg, S, Wostrack, M, Yusupov, N, Visser, V, Baaijen, J, Roux, A, Dezamis, E, Mandonnet, E, Corns, R, Duffau, H, Pallud, J, Zanello M., Goodden J. R., Colle H., Wager M., Hamer P. C. D. W., Smits A., Bello L., Tate M., Spena G., Bresson D., Capelle L., Robles S. G., Sarubbo S., Rydenhag B., Martino J., Meyer B., Fontaine D., Reyns N., Schichor C., Metellus P., Colle D., Robert E., Noens B., Muller P., Rossi M., Nibali M. C., Papagno C., Galbarritu L., De Gopegui E. R., Chioffi F., Bucheli C., Krieg S. M., Wostrack M., Yusupov N., Visser V., Baaijen J. C., Roux A., Dezamis E., Mandonnet E., Corns R., Duffau H., Pallud J., Zanello, M, Goodden, J, Colle, H, Wager, M, Hamer, P, Smits, A, Bello, L, Tate, M, Spena, G, Bresson, D, Capelle, L, Robles, S, Sarubbo, S, Rydenhag, B, Martino, J, Meyer, B, Fontaine, D, Reyns, N, Schichor, C, Metellus, P, Colle, D, Robert, E, Noens, B, Muller, P, Rossi, M, Nibali, M, Papagno, C, Galbarritu, L, De Gopegui, E, Chioffi, F, Bucheli, C, Krieg, S, Wostrack, M, Yusupov, N, Visser, V, Baaijen, J, Roux, A, Dezamis, E, Mandonnet, E, Corns, R, Duffau, H, Pallud, J, Zanello M., Goodden J. R., Colle H., Wager M., Hamer P. C. D. W., Smits A., Bello L., Tate M., Spena G., Bresson D., Capelle L., Robles S. G., Sarubbo S., Rydenhag B., Martino J., Meyer B., Fontaine D., Reyns N., Schichor C., Metellus P., Colle D., Robert E., Noens B., Muller P., Rossi M., Nibali M. C., Papagno C., Galbarritu L., De Gopegui E. R., Chioffi F., Bucheli C., Krieg S. M., Wostrack M., Yusupov N., Visser V., Baaijen J. C., Roux A., Dezamis E., Mandonnet E., Corns R., Duffau H., and Pallud J.

Abstract

BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.

Published
2019

3. Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers

Author

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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4. Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

Author

Bertil Rydenhag, Victoria Visser, Laurent Capelle, Hugues Duffau, Juan Martino, Marco Rossi, Damien Bresson, Maria Wostrack, Edurne Ruiz de Gopegui, Marco Conti Nibali, Philippe Metellus, Lorenzo Bello, Emmanuel Mandonnet, Sandro M. Krieg, Edouard Dezamis, David Colle, John Goodden, Matthew C. Tate, Johannes C. Baaijen, Nicolas Reyns, Philip C. De Witt Hamer, Johan Pallud, Giannantonio Spena, Bernhard Meyer, Lara Galbarritu, Natan Yusupov, Carlos Bucheli, Alexandre Roux, Erik Robert, Peter Barkholt Muller, Henry Colle, Denys Fontaine, Silvio Sarubbo, B. Noens, Santiago Gil Robles, Franco Chioffi, Michel Wager, Marc Zanello, Anja Smits, Robert Corns, Christian Schichor, Costanza Papagno, Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Leeds General Infirmary (LGI), Leeds Teaching Hospitals NHS Trust, Department of Neurosurgery, Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), VU University Medical Center [Amsterdam], Sahlgrenska Academy at University of Gothenburg [Göteborg], Uppsala University Hospital, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Feinberg School of Medicine, Northwestern University [Evanston], Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia [Brescia], Hôpital Lariboisière-Fernand-Widal [APHP], Service de Neurochirurgie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hospital Universitario Quironsalud, Department of Neurosciences, Division of Neurosurgery, 'S. Chiara' Hospital, Trento APSS – 9 Largo Medaglie D’Oro, Trento, 38122, Italy, Göteborgs Universitet (GU), Hospital Universitario Marqués de Valdecilla [Santander], Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Roger Salengro [Lille], University-Hospital Munich-Großhadern [München], Hôpital Privé Clairval [Marseille], Center for Mind/Brain Sciences (CIMEC), University of Trento [Trento], Hospital Universitario Cruces = Cruces University Hospital, Klinikums rechts der Isar, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Zanello, M, Goodden, J, Colle, H, Wager, M, Hamer, P, Smits, A, Bello, L, Tate, M, Spena, G, Bresson, D, Capelle, L, Robles, S, Sarubbo, S, Rydenhag, B, Martino, J, Meyer, B, Fontaine, D, Reyns, N, Schichor, C, Metellus, P, Colle, D, Robert, E, Noens, B, Muller, P, Rossi, M, Nibali, M, Papagno, C, Galbarritu, L, De Gopegui, E, Chioffi, F, Bucheli, C, Krieg, S, Wostrack, M, Yusupov, N, Visser, V, Baaijen, J, Roux, A, Dezamis, E, Mandonnet, E, Corns, R, Duffau, H, Pallud, J, Neurosurgery, and Amsterdam Neuroscience - Systems & Network Neuroscience

Subjects
Adult, Male, medicine.medical_specialty, Internationality, Return to work, Eloquent Brain Areas, Intraoperative brain mapping, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Preoperative care, Brain mapping, Angioma, Cohort Studies, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Predictive Value of Tests, Seizures, medicine, Humans, Karnofsky Performance Status, Retrospective Studies, Outcome, Brain Mapping, business.industry, Brain Neoplasms, Cavernous angioma, Retrospective cohort study, Odds ratio, Middle Aged, medicine.disease, Seizure, Surgery, Hemangioma, Cavernous, 030220 oncology & carcinogenesis, Hemosiderin, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neurology (clinical), business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P

Published
2019
Full Text
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5. Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas.

Author

Zanello M, Goodden JR, Colle H, Wager M, Hamer PCW, Smits A, Bello L, Tate M, Spena G, Bresson D, Capelle L, Robles SG, Sarubbo S, Rydenhag B, Martino J, Meyer B, Fontaine D, Reyns N, Schichor C, Metellus P, Colle D, Robert E, Noens B, Muller P, Rossi M, Nibali MC, Papagno C, Galbarritu L, de Gopegui ER, Chioffi F, Bucheli C, Krieg SM, Wostrack M, Yusupov N, Visser V, Baaijen JC, Roux A, Dezamis E, Mandonnet E, Corns R, Duffau H, and Pallud J

Subjects
Adult, Brain Mapping trends, Brain Neoplasms surgery, Cohort Studies, Female, Follow-Up Studies, Hemangioma, Cavernous surgery, Humans, Internationality, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Seizures surgery, Brain Mapping methods, Brain Neoplasms diagnostic imaging, Hemangioma, Cavernous diagnostic imaging, Karnofsky Performance Status, Seizures diagnostic imaging
Abstract

Background: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area., Objective: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery., Methods: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas., Results: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P = .013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P = .042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P < .001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P = .003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P < .001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P = .050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P = .039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P = .004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P = .045) are independent predictors of inability to work postoperatively., Conclusion: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas., (Copyright © 2019 by the Congress of Neurological Surgeons.)

Published
2019
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