[Cerebral cavernoma. A retrospective analysis of 24 cases]

We retrospectively analyzed 24 patients with cerebral cavernomas diagnosed according to histological and/or radiological criteria; epidemiological data, complementary techniques, therapy and evolution are reviewed and the cases are compared to those of previously reported series. Diagnosis was based on histological data in 18 patients and on magnetic resonance imaging (MRI) in the remaining 6. Five patients had compatible clinical histories symptoms compatible with the diagnosis. Mean age of the patients was 37.7 years, the most frequent location was the parietal lobe (27%), and seizures were the most common clinical symptoms of presentation (62%). Surgery was performed on 75%, sequelae were reported in 37.5% and exitus in 11%; 54% were asymptomatic. Six patients did not undergo surgery: 4 had multiple cavernomata, 1 received drug treatment that controlled the seizures and in 1 the cavernoma was located in the protuberance. We recommend the use of cerebral MRI for initial diagnosis, along with follow-up and investigation into similar profiles among family members. The treatment of choice is surgery in patients with acute, progressive or recurring deficits, and when lesions are superficial. At present there is no consensus about the treatment to follow when cavernomas are located in the brain stem.