<<snip>>
complete removal of cavernoma-surrounding hemosiderin-stained brain
tissue may improve epileptic outcome
<<snip>>
Seizure Outcome after Resection of Cavernous Malformations Is Better
When Surrounding Hemosiderin-stained Brain Also Is Removed.
Baumann CR, Schuknecht B, Lo Russo G, Cossu M, Citterio A, Andermann F,
Siegel AM
Epilepsia. 2006 Mar ; 47(3): 563-6
Summary: Purpose: Considering the epileptogenic effect of
cavernoma-surrounding hemosiderin, assumptions are made that resection
only of the cavernoma itself may not be sufficient as treatment of
symptomatic epilepsy in patients with cavernous malformations. The
purpose of this study was to test the hypothesis whether seizure
outcome after removal of cavernous malformations may be related to the
extent of resection of surrounding hemosiderin-stained brain tissue.
Methods: In this retrospective study, 31 consecutive patients with
pharmacotherapy-refractory epilepsy due to a cavernous malformation
were included. In all patients, cavernomas were resected, and all
patients underwent pre- and postoperative magnetic resonance imaging
(MRI). We grouped patients according to MRI findings (hemosiderin
completely removed versus not/partially removed) and compared seizure
outcome (as assessed by the Engel Outcome Classification score) between
the two groups. Results: Three years after resection of cavernomas,
patients in whom hemosiderin-stained brain tissue had been removed
completely had a better chance for a favorable long-term seizure
outcome compared with those with detectable postoperative hemosiderin
(p = 0.037). Conclusions: Our study suggests that complete removal of
cavernoma-surrounding hemosiderin-stained brain tissue may improve
epileptic outcome after resection of cavernous malformations.
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