Radiosurgery for Cavernous Malformations: Results of Long-Term Follow-Up

Radiosurgery ◽  
2004 ◽  
pp. 153-160 ◽  
Author(s):  
Y. Kida ◽  
T. Hasegawa
Keyword(s):  
Cavernous Malformations ◽  
Long Term Follow Up

710 Long-term Follow-up of Patients with Cavernous Malformations Treated by Stereotactic Radiosurgery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 509
Author(s):  
Toshinori Hasegawa MD ◽  
James McInerney MD ◽  
John Y.K. Lee ◽  
Douglas Kondziolka MD ◽  
John Flickinger MD ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Malformations ◽  
Long Term Follow Up

Multiple dynamic cavernous malformations in a girl: long-term follow-up

2009 ◽  
Vol 72 (6) ◽  
pp. 728-732 ◽  
Author(s):  
Liang Chen ◽  
Yao Zhao ◽  
Zheng Chen ◽  
May Tee ◽  
Ying Mao ◽  
...  
Keyword(s):  
Cavernous Malformations ◽  
Long Term Follow Up

scholarly journals Surgical treatment and outcome of cerebral cavernomas – a 10 years’ experience

2014 ◽  
Vol 21 (4) ◽  
pp. 395-405
Author(s):  
A. Giovani ◽  
Aurelia Sandu ◽  
Angela Neacsu ◽  
R.M. Gorgan
Keyword(s):  
Vascular Malformations ◽  
Clinical Status ◽  
Low Flow ◽  
Vascular Lesions ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Long Term Follow Up

Abstract Cavernous malformations (cavernomas) are congenital low flow angiographic occult vascular lesions with a high tencency to bleeding. The prevalence of cerebral cavernous vascular malformations is estimated to be 0.4% to 0.9%.2,7 CMs in deep locations, including the brainstem, thalamus, and basal ganglia, account for 9% to 35% of all malformations in the brain. We performed a retrospective 10 years study on 130 operated cerebral cavernomas and discussed the clinical status at presentation, the choice and timing of the surgical approach and the short and longterm follow up. The 130 operated cases were divided into a supratentorial 102 (78.46%) group and an infratantorial group 28 (21.53%). The average age at presentation was 43,62 years old (17-76) and there was no sex predominance, male/female = 1,44 (77/53). Only in 14 cases (10.76%) we could find multiple cavernomas which had relatives with multiple cavrnomas, but the familial inheritance was not studied, and only the symptomatic lesion was resected. We divided the outcome results reporting for agroup with superficial respectively profound lesions. The long term follow up for the patients in the profound lesions group showed that 31/37 (83,78%) of patients had a mRS between 0 and 2, and the rest had a poor long term outcome. After surgery there was no clinical deterioration in the superficial lesions group and 22 patients from those who presented in mRS 2 showed neurological improvement on long term follow up, meaning that 82,79% of patients had a 0 or 1 mRS. Microsurgery is the treatment of choice in symptomatic brain cavernomas, total resection being the only curative treatment, capable to prevent further bleeding and to offer an efficient control of seizures.

710 Long-term Follow-up of Patients with Cavernous Malformations Treated by Stereotactic Radiosurgery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 509-509
Author(s):  
Toshinori Hasegawa MD ◽  
James McInerney MD ◽  
John Y.K. Lee ◽  
Douglas Kondziolka MD ◽  
John Flickinger MD ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cavernous Malformations ◽  
Long Term Follow Up

Cavernous malformations of the brain after treatment for acute lymphocytic leukemia: presentation and long-term follow-up

2013 ◽  
Vol 11 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Amit Singla ◽  
Jill E. Brace O'Neill ◽  
Edward Smith ◽  
R. Michael Scott
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Clinical Course ◽  
Lymphocytic Leukemia ◽  
Incomplete Resection ◽  
Cavernous Malformations ◽  
Cranial Radiation ◽  
Long Term Follow Up ◽  
The Brain

Object The authors undertook this study to determine the clinical course and long-term outcomes in pediatric patients who developed cavernous malformations of the brain following treatment for acute lymphocytic leukemia (ALL). Methods They reviewed the senior author's database of surgically treated cavernous malformations of the brain to identify those patients whose cavernous malformations developed after cranial radiation during treatment for ALL. The medical records of these patients were reviewed to determine their clinical presentation, radiological findings, and outcome at long-term follow-up. Results Five patients fulfilled the specified criteria over a 23-year period. At the time of ALL diagnosis, they were all 4–5 years old. The cerebral cavernous malformations developed 2–8 years after cranial radiation, and 4 of the 5 patients presented with neurological symptoms, which ranged from focal deficits to seizures. Two patients required a second craniotomy, one from lesion recurrence possibly due to incomplete resection, and another for a second cavernous malformation, which developed at another site 6 years after the initial malformation was excised. Long-term follow-up of 2, 10, 11, 11, and 17 years has revealed no additional lesion development or recurrence. Conclusions Symptomatic cavernous malformations of the brain may develop several years after chemotherapy and cranial radiation treatment for ALL, and the clinical course of these cavernous malformations may be more aggressive than that of the typical post-radiation lesions seen in other conditions. Long-term clinical and imaging monitoring is recommended for children who have undergone treatment for ALL. Craniotomy for excision of the malformations appears to convey long-term protection from repeat hemorrhage and accumulating neurological deficits.

Resection of supratentorial lobar cavernous malformations in children

2013 ◽  
Vol 12 (4) ◽  
pp. 367-373 ◽  
Author(s):  
Bradley A. Gross ◽  
Edward R. Smith ◽  
Liliana Goumnerova ◽  
Mark R. Proctor ◽  
Joseph R. Madsen ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Neurological Complication ◽  
Complete Resection ◽  
Long Term Results ◽  
Cavernous Malformations ◽  
Radiographic Findings ◽  
Operative Outcomes ◽  
Long Term Follow Up

Object The authors present a series of children with supratentorial lobar cavernous malformations (CMs). Current imaging and operative techniques along with long-term follow-up were incorporated to characterize the response to surgical treatment in this pediatric population. Methods The senior author's operative experience was reviewed retrospectively along with a review of the Boston Children's Hospital database from 1997 to 2011 for children with supratentorial lobar CMs. Lobar CM was defined as having a supratentorial location but not involving the thalamus/hypothalamus or basal ganglia. Baseline patient demographics, pertinent radiographic findings, operative outcomes, and long-term results were evaluated and compared between patients managed operatively and those who were managed nonoperatively. Results Of 238 CMs identified, 181 (76%) were lobar. Compared with patients managed with observation only, those selected for surgery were older (p = 0.03), more likely to have symptomatic lesions (p < 0.001), and had larger lesions (p < 0.001). Of the 83 CMs selected for surgery, 98% were completely resected. Over a total of 384.5 patient-years of follow-up after surgery (mean 4.6 years; median 2.7 years; range 0.1–22.3 years), there were no subsequent hemorrhages in any patient undergoing complete resection; 1 of the 2 incompletely resected lesions rebled during the follow-up period. Radiographically, there was 1 recurrence (1.2%) in a child with multiple CMs; there were no recurrences of completely resected single lesions. Of the 48 patients who presented with seizures (acute or chronic), 46 (96%) were seizure free at follow-up. The permanent neurological complication rate of surgery was 5%; these complications were limited to those patients whose lesions were in eloquent locations. Conclusions Pediatric patients with symptomatic supratentorial lobar CMs are ideal candidates for surgery, for which there are high complete resection rates, rewarding long-term seizure outcomes, and low operative morbidity. Observation may be warranted in smaller asymptomatic lesions located within eloquent cortex.

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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