Clinical Neuroscience

Management of cavernous angiomas of eloquent brain areas by means of image (MRI or CT) - guided key-hole craniotomy

KÖVÉR Ferenc1, DÓCZI Tamás2, VON JAKO C.3, BALÁS István2

SEPTEMBER 20, 1997

Clinical Neuroscience - 1997;50(09-10)

Details of neurosurgical management of four patients suffering from intractable epilepsy caused by cavernous angiomas of subcortical eloquent brain areas are presented. Two of four cavernomas were not visualized by CT or angiography but only by MRI. MRI or CT stereotactic image-guided key-hole craniotomy and resection of the lesion from the dominant anterior central gyrus (2 cases), from the dominant superior temporal gyrus or from the dominant supramarginal gyrus were performed without any morbidity. The postoperative hospital stay was 3-5 days and all four patients experienced improved seizure control. We conclude that stereotactic image-guided key-hole craniotomy and microsurgical resection offer significant advantages in the treatment of cavernous malformations. Surgical indications include medically refractory epilepsy, intracerebral haemorrhage and/or progressive neurological deficit.

AFFILIATIONS

  1. University Medical School, and Diagnostic Center of Pécs
  2. Department of Neurosurgery, Hungary
  3. Radionics Inc., Burlington, MA, USA

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