Related Experiment Video
Updated: May 30, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Clinical features and microsurgical treatment of pediatric patients with cerebral cavernous malformation
Jianping Song1, Nidan Qiao, Liqian Xie
1Department of Neurosurgery, HuaShan Hospital, Shanghai Medical College, FuDan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China.
Insights
Pediatric cerebral cavernous malformations (CCM) often cause seizures and hemorrhages. Early microsurgical treatment, using advanced imaging and minimally invasive techniques, leads to seizure freedom and neurological improvement in most children.
Area of Science:
- Pediatric Neurosurgery
- Neurology
- Medical Imaging
Background:
- Cerebral cavernous malformations (CCM) are vascular malformations in the brain.
- Pediatric CCM can present with significant neurological symptoms like seizures and hemorrhages.
- Understanding clinical features and surgical outcomes is crucial for effective management.
Purpose of the Study:
- To describe the clinical presentation of pediatric cerebral cavernous malformations (CCM).
- To evaluate the outcomes of microsurgical treatment for pediatric CCM.
- To identify key factors contributing to successful surgical intervention.
Main Methods:
- Retrospective investigation of 85 pediatric patients with CCM (aged 6 months to 17.9 years).
- Microsurgical treatment was performed on 80 patients, utilizing neuronavigation, intraoperative ultrasonography, and functional MRI for precise lesion localization.
- Minimally invasive surgical techniques were employed.
Main Results:
- Seizures and symptomatic hemorrhages were the most frequent symptoms, affecting 81 patients.
- No deaths occurred among the 80 surgically treated patients.
- Postoperative seizure control was achieved in 9 patients; 27 patients showed improved neurological deficits, with gradual recovery in 9 during follow-up.
Conclusions:
- Early microsurgical intervention is recommended for pediatric patients with CCM.
- Accurate lesion localization using advanced neuroimaging (functional MRI) and minimally invasive techniques are critical for successful surgical outcomes.
- Microsurgery demonstrates significant efficacy in managing pediatric CCM, leading to seizure control and neurological recovery.
Abstract:
The aim of the present study was to describe the clinical features and to evaluate the surgical treatment outcomes of pediatric patients with cerebral cavernous malformations (CCM). We investigated 85 children (53 boys and 32 girls), aged from 6 months to 17.9 years with CCM. Seizures and symptomatic hemorrhages, which were the most frequent symptoms, occurred in 81 patients. Nine patients had a positive family history of CCM. Eighty patients underwent microsurgical treatment after strict operative indications were met. Neuronavigation, combined with intraoperative ultrasonography or functional MRI, was used for precise localization of the lesions. The principles of minimally invasive techniques were followed during surgery. A total of 89 lesions were removed in 80 patients, and there were no deaths. During their hospital stay, only nine patients suffered from postoperative seizures, which were controlled with medication. Postoperative neurological deficits improved in 27 patients, were unchanged in nine, and worsened in two. With the help of advanced neuroimaging, a satisfactory surgical outcome was achieved for 10 lesions located in eloquent brain areas and four lesions in the brain stem. A follow-up study of 66 patients showed that all of these patients remained seizure-free, and nine patients with postoperative neurological deficits gradually recovered. Microsurgical treatment should be performed early for pediatric patients with CCM. Accurate localization of the lesions and the use of minimally invasive techniques and functional MRI monitoring were the key features of the surgical procedures.
