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[Central nervous system cavernomas in children].

G Lena1, J Ternier, A Paz-Paredes

  • 1Unité fonctionnelle de neurochirurgie pédiatrique, hôpital des enfants de La Timone, 286 rue Saint-Pierre, 13385 Marseille cedex 05, France. gabriel.lena@ap-hm.fr

Neuro-Chirurgie
|May 18, 2007
PubMed
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Cavernomas are vascular malformations in children, often presenting with hemorrhage or neurological deficits. Surgical intervention for symptomatic or hemorrhagic lesions significantly improves outcomes, with most children remaining neurologically intact post-surgery.

Area of Science:

  • Pediatric Neurology
  • Vascular Malformations
  • Neurosurgery

Context:

  • Cavernomas are a type of cerebral vascular malformation found in children.
  • Hemorrhage is a frequent complication in pediatric cavernomas, occurring in up to 78% of cases.
  • Lesions are predominantly supratentorial (79.4%), with a significant proportion in the brainstem.

Purpose:

  • To review the clinical presentation, location, management, and outcomes of pediatric cavernomas.
  • To highlight the efficacy of surgical management for symptomatic or hemorrhagic lesions.
  • To provide insights into the current consensus on cavernoma treatment.

Summary:

  • Pediatric cavernomas manifest with hemorrhage (27.3-78%), epilepsy (16-60%), and neurological deficits (22.7%).

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  • Management favors medical treatment for asymptomatic cases and surgical intervention for symptomatic/hemorrhagic lesions.
  • Surgical outcomes are encouraging, with approximately 70% of children remaining neurologically intact post-operatively.

    • Impact:

    • Advances in neuroimaging and surgical techniques have improved the management of pediatric cavernomas.
    • Surgical intervention for epilepsy associated with cavernomas shows promising results, especially for non-temporal lobe lesions.
    • Effective management strategies lead to favorable neurological outcomes in the majority of pediatric patients.