Journal article
Recurrence of cavernous malformations after surgery in childhood
Journal of neurosurgery. Pediatrics, v 26(2), pp 179-188
01 Aug 2020
PMID: 32357336
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
OBJECTIVE Cavernous malformations (CMs) are commonly treated cerebrovascular anomalies in the pediatric population; however, the data on radiographic recurrence of pediatric CMs after surgery are limited. The authors aimed to study the clinical presentation, outcomes, and recurrence rate following surgery for a large cohort of CMs in children.
METHODS Pediatric patients (<= 18 years old) who had a CM resected at a single institution were identified and retrospectively reviewed. Fisher's exact test of independence was used to assess differences in categorical variables. Survival curves were evaluated using the Mantel-Cox method.
RESULTS Fifty-three patients aged 3 months to 18 years underwent resection of 74 symptomatic CMs between 1996 and 2018 at a single institution. The median length of follow-up was 5.65 years. Patients most commonly presented with seizures (45.3%, n = 24) and the majority of CMs were cortical (58.0%, n = 43). Acute radiographic hemorrhage was common at presentation (64.2%, n = 34). Forty-two percent (n = 22) of patients presented with multiple CMs, and they were more likely to develop de novo lesions (71%) compared to patients presenting with a single CM (3.4%). Both radiographic hemorrhage and multiple CMs were independently prognostic for a higher risk of the patient requiring subsequent surgery. Fifty percent (n = 6) of the 12 patients with both risk factors required additional surgery within 2.5 years of initial surgery compared to none of the patients with neither risk factor (n = 9).
CONCLUSIONS Patients with either acute radiographic hemorrhage or multiple CMs are at higher risk for subsequent surgery and require long-term MRI surveillance. In contrast, patients with a single CM are unlikely to require additional surgery and may require less frequent routine imaging.
Metrics
Details
- Title
- Recurrence of cavernous malformations after surgery in childhood
- Creators
- Laura M. Prolo - Stanford UniversityMichael C. Jin - Stanford UniversityTina Loven - St. Christopher's Hospital for ChildrenHannes Vogel - Stanford UniversityMichael S. B. Edwards - Stanford UniversityGary K. Steinberg - Stanford UniversityGerald A. Grant - Stanford University
- Publication Details
- Journal of neurosurgery. Pediatrics, v 26(2), pp 179-188
- Publisher
- Amer Assoc Neurological Surgeons
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery; Neurosurgery
- Web of Science ID
- WOS:000577148500001
- Scopus ID
- 2-s2.0-85090122627
- Other Identifier
- 991021933313504721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Pediatrics
- Surgery