Cerebral cavernous malformations (cavernomas) in the pediatric age-group.

Area of Science:

• Neurology
• Vascular Malformations
• Pediatric Neurosurgery

Background:

• Cavernous malformations are vascular malformations characterized by abnormal, closely packed sinusoidal vessels without intervening brain tissue.
• Historically considered rare and predominantly adult-onset, recent advances in neuroradiology suggest increased prevalence in pediatric populations.

Purpose of the Study:

• To investigate the incidence, clinical presentation, diagnostic methods, and treatment outcomes of cavernous malformations in pediatric patients.
• To highlight the underestimation of cavernous malformation frequency in children.

Main Methods:

• Retrospective review of 17 pediatric patients diagnosed with cavernous malformations between 18 months and 16 years of age.
• Utilized computed tomography (CT) and magnetic resonance imaging (MRI) for diagnosis, alongside cerebral angiography.
• Assessed clinical symptoms, familial history, and treatment outcomes, primarily focusing on surgical intervention.

Main Results:

• 17 pediatric cases identified, with 16 diagnosed post-1982, indicating improved detection.
• Hemorrhage was the most frequent initial symptom (12 cases), followed by epileptic seizures (4 cases).
• CT and MRI demonstrated high diagnostic accuracy (100% and highly significant, respectively), while angiography was less sensitive.

Conclusions:

• Cavernous malformations are more prevalent in pediatric patients than previously recognized.
• Advanced imaging techniques like CT and MRI are crucial for diagnosing these lesions in children.
• Radical surgical excision is an effective treatment, with excellent results in most cases.