Surgical management of brain cavernomas in children

Abstract

Background: Cavernous hemangiomas are benign vascular hamartomas caused by developmental malformations of the vascular bed. They can be found in 0.3-0.7% of the population, whereas one fourth of these lesions occur in children.

Methods: In the present study, we report on 16 cases of cavernomas surgically treated in our institute. From each patient's file, the age, sex, lesion location, symptoms and follow-up were analyzed.

Results: The most commonly presenting symptom was epilepsy. Radiological signs of acute hemorrhage were observed in 3 cases. Three children had multiple cavernomas. The parietal lobe was the most common site of occurrence, whereas only 2 cavernomas were infratentorial. There was no operative mortality. Postoperatively, there was no additional neurological deficit, and all patients gradually improved. In a case of pontine cavernoma, there was a need for reoperation due to rebleeding.

Conclusion: With the improvement of microsurgical techniques and modern neuroimaging, nearly all cavernomas can be safely removed. Total resection is associated with patients' clinical improvement and seizure control.