Baumann Christian R, Schuknecht Bernhard, Lo Russo Giorgio, Cossu Massimo, Citterio Alberto, Andermann Frederick, Siegel Adrian M
Department of Neurology, University Hospital, Zürich, Switzerland.
Epilepsia. 2006 Mar;47(3):563-6. doi: 10.1111/j.1528-1167.2006.00468.x.
Considering the epileptogenic effect of cavernoma-surrounding hemosiderin, assumptions are made that resection only of the cavernoma itself may not be sufficient as treatment of symptomatic epilepsy in patients with cavernous malformations. The purpose of this study was to test the hypothesis whether seizure outcome after removal of cavernous malformations may be related to the extent of resection of surrounding hemosiderin-stained brain tissue.
In this retrospective study, 31 consecutive patients with pharmacotherapy-refractory epilepsy due to a cavernous malformation were included. In all patients, cavernomas were resected, and all patients underwent pre- and postoperative magnetic resonance imaging (MRI). We grouped patients according to MRI findings (hemosiderin completely removed versus not/partially removed) and compared seizure outcome (as assessed by the Engel Outcome Classification score) between the two groups.
Three years after resection of cavernomas, patients in whom hemosiderin-stained brain tissue had been removed completely had a better chance for a favorable long-term seizure outcome compared with those with detectable postoperative hemosiderin (p=0.037).
Our study suggests that complete removal of cavernoma-surrounding hemosiderin-stained brain tissue may improve epileptic outcome after resection of cavernous malformations.
鉴于海绵状血管瘤周围含铁血黄素的致痫作用，有人认为对于海绵状血管畸形患者，仅切除海绵状血管瘤本身可能不足以治疗症状性癫痫。本研究的目的是检验以下假设：切除海绵状血管畸形后的癫痫发作结果是否可能与周围含铁血黄素染色脑组织的切除范围有关。
在这项回顾性研究中，纳入了31例因海绵状血管畸形导致药物治疗难治性癫痫的连续患者。所有患者均接受了海绵状血管瘤切除术，且所有患者均接受了术前和术后磁共振成像（MRI）检查。我们根据MRI结果（含铁血黄素完全切除与未切除/部分切除）对患者进行分组，并比较两组之间的癫痫发作结果（通过Engel结局分类评分评估）。
海绵状血管瘤切除术后三年，与术后仍可检测到含铁血黄素的患者相比，含铁血黄素染色脑组织被完全切除的患者获得良好长期癫痫发作结果的机会更大（p=0.037）。
我们的研究表明，完全切除海绵状血管瘤周围含铁血黄素染色的脑组织可能会改善海绵状血管畸形切除术后的癫痫结局。
