[Microsurgical treatment of temporal cavernous malformation presenting with epilepsy]

Objective: To evaluate the efficacy and safety of microsurgical in the treatment of temporal lobe cerebral cavernous malformation (CCM) with epilepsy. Methods: Temporal lobe CCM patients with epilepsy admitted to our department were collected from January 2010 to September 2016. Locations of the CCM were divided into (1) lateral-lateral to the collateral sulcus; (2) mesial-mesial to the collateral sulcus. In the lateral group, patients were underwent intraoperative electrocorticography (ECoG)-guided resection of lesion and hemosiderin rim. In the medial group, a complete resection of the epileptogenic zone was performed in anterior temporal lobe and hippocampus and (or) amygdala according to lesion and hemosiderin rim. The follow-up period in all patients was at least 1 year. The outcome of epilepsy treatment was evaluated according to the standard Engel scale. Results: Eight patients belong to the lateral group, including 2 males and 6 females, mean age at epilepsy surgery was 35 years old, 100% of patients achieved Engel class Ⅰ the last follow up. The mesial group had 7 patients, including 4 males and 3 females, mean age at epilepsy surgery was 52 years old, 71.8% of the patients were Engel Class Ⅰ, 14% were Class Ⅱ, and 14% were Class Ⅲ. The patient who was Engel Class Ⅲ had a posterior temporal venous infarction due to injured the developmental venous anomalies (DVAs). Conclusions: CCM Patients with epilepsy could benefit greatly from complete resection of hemosiderin rim and lesion. The epilepsy prognosis were closely correlated with the location of CCM. Further research is necessary to determine therapeutic strategies of CCMs with associated DVAs.