Management of Cavernous Angiomas

The purpose of this study is to evaluate the clinical informations(symptoms, pathophysiologic phenomena, other associated vascular malformation and outcome) in order to define the guide of the management.

The authors reviewed the 54cases which were diagnosed by the high-resolution MRI and supplemented by computed tomography, from 1991 to 1996. The patho-physiologic phenomena of the CMs were classified into three groups by the finding of MRI. Surgical outcome was analysed according to the type of lesions, clinical variables, and indication of surgical management.

The mean patient age was 33.2 years, and the locations of CMs are in the cere-brum in 38 cases, basal ganglia/thalamus in 5 cases, brain stem in 16 cases, orbit in 2 cases and the spinal cord in 1case. Symptomatic hemorrhage were 25 patients(46%), seizure reported 16 patients(30%) and focal neurologic deficit 7(13%). Incidental cases were founded in 6 patients(11%) and their main complaints were headache. In 71% of the patients, the lesions were solitary and multiple in 29%. The 7 patients had coexisting venous angiomas. The A group had 24 patients(44%), B group 16 patients(30%) and the C group 14 patients(26%). Twenty nine patients who were asymptomatic or incidentally discovered lesions(6 patients) were treated conservatively. Twenty five patients(15 hemorrhage, 8 patients of intractable seizure and 2 patients of progressive neurologic deficits) underwent surgery.

This study suggest that surgical extirpation of the lesions is an effective management in accessible lesions, overt hemorrhage, medical intractable epilepsy and pro-gressive worsening focal neurologic deficits.