Surgical Management of Intracranial Cavernous Malformations: The Louisiana State University Health Sciences Center, Shreveport Experience

Abstract

Intracranial cavernous malformations are vascular anomalies consisting of endothelium-lined caverns filled with blood at various stages of thrombosis and organized and separated by a collagenous stroma devoid of mature vessel wall elements. They represent a clinical challenge both in diagnosis and management due to the variety of presenting symptoms and neuroradiological features. This study analyzes the clinical manifestations and surgical outcomes in 16 patients with cavernous malformations who were treated surgically at the Louisiana State University Health Sciences Center in Shreveport. The most common presenting features were headache, seizure, and focal neurologic deficits. Three patients had deep lesions (two in the brainstem and one in the basal ganglion), and 13 patients had superficial lesions. All patients underwent surgery and had complete excision of the lesion. The overall outcome was satisfactory for all patients with significant symptom relief over a mean follow-up period of 60 months. The optimal management of cavernous malformations should be determined on a case-by-case basis and, when indicated, surgery provides good outcome.