[Diagnosis and operative treatment cavernous angiomas of the central nervous system]

Among all detected cerebral angiomas the frequency of cavernous angiomas (CAs) is 5-13%. The aim of this study is to present the diagnostic methods of CA of the central nervous system (CNS), indications for surgery and assessment of its outcome. Between 1993-2000, eleven cases of CAs were operated on at the Department of Neurosurgery, Medical College, Jagiellonian University in Krakow. In 6--seizures were observed, in 4--headache (supratentorial CAs), increasing neurological deficits in 4 (location in vertebral channel and cerebellum), hemorrhage--1 case (CA in pons combined with supratentorial lesion). Surgery was carried out by means of craniotomy, and via laminectomy in the cases of spinal channel tumours. Early and late outcome were assessed in following cathegories: very good, good, fair, bad (significant deterioration). The shortest late observation was 5 years. Direct very good surgical outcome was attained in 4 cases (36%), good in 4. (36%), fair in 2. (18%), bad in 1 case. In late observation, 7 patients were very good (64%), and 3 good (27%). In one case the neurological improvement was poor, later observed--late outcome was fair. In 6 cases they suffered from frequent epileptic seizures before surgery; they were seizure free in the late assessment.

(1) direct surgical outcome in CA of the CNS is good and very good in the majority of cases; (2) in late observation, further neurological improvement allows to attain over 90% good and very good outcomes; (3) the high antiepileptic effectiveness after surgery of CA is observed.