+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Cavernous malformations of the central nervous system in the pediatric age group



Cavernous malformations of the central nervous system in the pediatric age group



Pediatric Neurosurgery 45(2): 81-104



The main clinico-diagnostic features, risk factors and associated diseases of cavernous malformations (CMs), also called cavernous angiomas or cavernomas, of the central nervous system (CNS) in children are described, and the most relevant differences compared to the affected adult population are pointed out, focusing on the management of pediatric patients harboring cranial and spinal CMs. This was a retrospective study of a series of 42 children symptomatic for CMs of the cranial and spinal compartments (35 supratentorial brain lesions, 5 infratentorial and 2 in the spinal region) operated on between 1975 and 2005, with a clinical follow-up ranging from 12 to 192 months. The results were compared with those found in the most recent literature dealing with pediatric CMs of the CNS. Surgical treatment produced excellent or good results in 69% of our 42 children. Unchanged neurological deficits were observed in 23.8% of cases, while morbidity from surgical procedures was 7.14%. Mortality was absent in this series. These surgical results are comparable with those found in the literature, where morbidity and mortality rates from surgery are 8.8 and 1.13%, respectively, and are mostly associated with procedures for the excision of deep, critically located cavernomas. CMs represent the most common CNS vascular lesion in children, although their incidence is 4 times lower than that of the adult population. The natural history of pediatric CMs throughout the neuraxis seems to be more aggressive than in adult patients; these lesions have higher rates of growth and hemorrhage, larger dimensions and often atypical radiological pictures at diagnosis. Beside the familial form of the disease, which is more often associated with multiple lesions and an earlier age of clinical presentation, the major risk factor for CMs in children seems to be radiotherapy for CNS tumors. Furthermore, a greater number of CMs coexistent with mixed angiomatous lesions have been reported in children than in adults. Surgical results are related to the preoperative neurological status of the children; symptomatic patients who are operated on early, before they develop severe neurological deficits or long-standing seizures, may achieve the best clinical outcome. Radiosurgery does not seem to be advisable in children as an alternative treatment for deep CMs or those causing epilepsy.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 051976982

Download citation: RISBibTeXText

PMID: 19307743

DOI: 10.1159/000209283


Related references

Cavernous malformations of the pediatric central nervous system. Operative Techniques in Neurosurgery 5(3): 150-154, 2002

Cavernous malformations of central nervous system in pediatric patients: our single-centered experience in 50 patients and review of literature. Child's Nervous System, 2017

Familial cavernous malformations of the central nervous system and retina. Annals of Neurology 21(6): 578-583, 1987

Treatment options for central nervous system cavernous malformations in children. European Journal of Paediatric Neurology 15(3): 281-281, 2012

Cavernous malformations associated with dural arteriovenous shunts in the central nervous system. Neuroradiology 55(2): 187-192, 2013

Temporal clustering of hemorrhages from untreated cavernous malformations of the central nervous system. Neurosurgery 49(1): 15-24; Discussion 24-5, 2001

Cavernous malformations of the central nervous system in children: presentation, treatment and outcome of 20 cases. European Journal of Paediatric Neurology 15(2): 109-116, 2012

Factors associated with epileptic seizure of cavernous malformations in the central nervous system in West China. Pakistan Journal of Medical Sciences 29(5): 1116-1121, 2013

Inherited cavernous malformations of the central nervous system: clinical and genetic features in 19 Swiss families. Neurosurgical Review 33(1): 47-51, 2010

Formation of intracerebral cavernous malformations after radiation treatment for central nervous system neoplasia in children. Journal of Neurosurgery 88(1): 51-56, 1998

Review of the literature on de novo formation of cavernous malformations of the central nervous system after radiation therapy. Neurosurgical Focus 21(1): E4-E4, 2006

Familial cavernous malformations of the central nervous system. A clinical and genetic study of 15 German families. Der Nervenarzt 76(2): 175-180, 2005

Widespread central nervous system cavernous malformations associated with café-au-lait skin lesions. Case report. Journal of Neurosurgery 99(2): 412-415, 2003

Cavernous malformations of the central nervous system (CNS) in children: clinico-radiological features and management outcomes of 36 cases. Child's Nervous System 30(8): 1355-1366, 2015

Hemangiomas of the central nervous system in Japan: an epidemiological and clinicopathological study with special reference to venous and cavernous malformations. Neurosurgical Review 9(3): 221-231, 1986