Surgical Strategy of Brainstem Cavernous Malformation and Neurologic Outcome
김민정, 이상훈, 김의현, 장종희, 이규성, 홍창기,
소속 상세정보
김민정 ( Kim Min-Jeoung )
Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
이상훈 ( Lee Sang-Hun )
Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery
김의현 ( Kim Eui-Hyun )
Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
장종희 ( Chang Jong-Hee )
Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
이규성 ( Lee Kyu-Sung )
Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery
홍창기 ( Hong Chang-Ki )
Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery
KMID : 1037420190140020016
Abstract
Background : Brainstem cavernous malformation (BSCM) is a rare pathology that causes repeated bleeding in the brainstem. The anatomical complexity of the brainstem and high surgical morbidity and mortality rates make surgery difficult. Several authors have shared their experience of surgical removal of BSCM.
Methods : Patients diagnosed with BSCM in single institution from 2006 to 2017 were investigated retrospectively. A modified Rankin scale (mRS) was used to assess patients’ neurological status. During surgery, neuronavigation and neuromonitoring were used.
Results : The total number of 16 patients were reviewed. The telovelar approach was used most frequently (7 times). mRS on admission versus mRS at last follow up (p = 0.008) and mRS at immediate postoperative versus mRS at last follow-up showed significant difference (p = 0.001). Postoperative neurological deteriorations were noticed in 8 of 16 patients. Neurological outcomes were improved after more than 6 months later during follow up periods.
Conclusions : In this study, neurological status may be deteriorated in immediate postoperative but neurological status will be better when followed up for more than 6 months. Surgical techniques and equipment such as high-resolution magnetic resonance imaging, diffusion tensor imaging, 3-dimensional modeling, neuronavigation, and neuromonitoring help surgery of BSCM. So BSCM should be surgically treated in active stance.
키워드
Brain Stem; Cavernous malformation
원문 및 링크아웃 정보
등재저널 정보