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Central nervous system cavernomas in the pediatric age group
C Mottolese1, M Hermier, H Stan
1Department of Pediatric Neurosurgery, Université Claude-Bernard Lyon-I, Hĵpital Neurologique et Neurochirurgique P. Wertheimer, France.
Neurosurgical Review
|August 4, 2001
Summary
Pediatric central nervous system (CNS) cavernomas present a high hemorrhagic risk and unique imaging features in children. Surgical excision is the primary treatment for symptomatic lesions, though more research on natural history is needed.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Neuroradiology
Background:
- Central nervous system (CNS) cavernomas are challenging pediatric lesions.
- Adult cavernoma natural history is known, but pediatric data is limited.
- Previous studies often combined adult and pediatric cases.
Purpose of the Study:
- Focus on pediatric CNS cavernoma clinical, imaging, and therapeutic features.
- Highlight specificities of cavernomas in the pediatric age group.
- Propose an imaging classification for pediatric cerebral cavernomas.
Main Methods:
- Literature review and single-center experience (36 operated, 7 unoperated pediatric cases).
- Analysis of clinical presentation, imaging findings, and treatment outcomes.
- Development of a pediatric-specific imaging classification.
Main Results:
- Pediatric cavernomas have a high hemorrhagic risk, similar to adults.
- Lesions often present with sudden intracerebral hematoma and neurological deficits.
- Proposed imaging classification aids diagnosis, identifying sharply demarcated lesions.
- Surgical excision is effective for symptomatic and growing lesions.
Conclusions:
- Pediatric CNS cavernomas require specific diagnostic and therapeutic approaches.
- Microsurgical excision offers good outcomes for operated children.
- Further research on the natural history of pediatric cavernomas is essential for optimal management.