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Journal of Korean Neurosurgical Society 1997;26(6): 846-852.
The Role of Surgical Treatment and Clinical Outcome in Patients with Intracranial Cavernous Angiomas.
Chang Wan Oh, Young Seob Chung, Dong Gyu Kim, Sun Ha Paek, Byung Kyu Cho, Kyu Chang Wang, Dae Hee Han
Department of Neurosurgery, College of Medicine, Seoul National University, Seoul, Korea.
In order to analyze and evaluate the role of surgical treatment and clinical outcome in patients with intracranial cavernous angiomas, we retrospectively reviewed the medical records of 30 patients who underwent surgery between 1988 and 1995. Preoperative symptoms and signs were intracranial hemorrhage(ICH) in 16 cases(53%), seizure in 14(47%) and neurologic deterioration due to effect of the mass in seven(23%). Four of the 16 patients admitted because of ICH had a previous history of this condition. Intervals between hemorrhages varied from 5 days to 20 months, with a mean of 7.4 months. The mass was removed gross-totally in 27 patients, subtotally in two and partially in one; post-operative neurologic status was aggravated in only two patients. Lesions had recurred in five of the 27 patients from whom these were thought to have been totally removed; in one case, there was recurrent hemorrhage sixteen months after surgery. Four of the five recurrent cases had been operated on immediately after ICH, and in the other a lesion which contained calcification had been seen. Only one of the 12 patients who had shown preoperative seizures and was followed up for at least 12 months after surgery continued to suffer from seizures after removal of the lesion. In conclusion, our study demonstrated that after initial bleeding, hemorrhaging tends to recur in thses lesions, and that if they are removed immediately after ICH, there is a risk that the angioma may recur.
Key Words: Cavernous angioma; Intracranial hemorrhage; Seizure; Recurrence
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