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小儿脑海绵状血管畸形相关性癫痫的外科治疗及长期预后

Surgical Treatment and Long-Term Outcome of Cerebral Cavernous Malformations-Related Epilepsy in Pediatric Patients.

作者信息

Lin Qiao, Yang Peng-Fan, Jia Yan-Zeng, Pei Jia-Sheng, Xiao Hui, Zhang Ting-Ting, Zhong Zhong-Hui, Wang Shou-Sen

机构信息

Department of Neurosurgery, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China.

Department of Epileptology, Fuzhou General Hospital, Fujian Medical University, Fuzhou, China.

出版信息

Neuropediatrics. 2018 Jun;49(3):173-179. doi: 10.1055/s-0038-1645871. Epub 2018 Apr 20.

Abstract

Cerebral cavernous malformations (CMs) are vascular malformations affecting any part of the central nervous system. Clinical data and surgical outcomes for 27 pediatric patients with CM-related epilepsy were retrospectively reviewed. The mean age of onset was 12.71 ± 4.09 years, and the mean duration of epilepsy was 2.34 ± 1.95 years. All 27 patients were treated with microsurgery for resection of the CMs, and the hemosiderin rim, and the secondary epileptogenic zone if necessary. The mean follow-up period was 6.34 ± 3.35 years, and the overall postoperative outcomes were positive. Note that 77.8% of patients were seizure-free postoperatively. The other patients with residual epilepsy received incomplete resection of the hemosiderin rim or the secondary epileptogenic zone due to retention of vital neurological functions. Surgical treatment for pediatric patients with symptomatic supratentorial CMs is safe and effective. Early intervention is recommended to resect CMs, the hemosiderin rim, and the epileptogenic cortex, even in cases of multiple CMs.

摘要

脑海绵状血管畸形(CMs)是一种影响中枢神经系统任何部位的血管畸形。对27例与CM相关的癫痫患儿的临床资料和手术结果进行了回顾性分析。平均发病年龄为12.71±4.09岁,平均癫痫病程为2.34±1.95年。所有27例患者均接受显微手术切除CMs、含铁血黄素环以及必要时的继发性癫痫灶。平均随访时间为6.34±3.35年,总体术后结果良好。注意,77.8%的患者术后无癫痫发作。其他仍有癫痫发作的患者由于保留了重要神经功能,含铁血黄素环或继发性癫痫灶切除不完全。对于有症状的幕上CMs患儿,手术治疗是安全有效的。即使在多发CMs的情况下,也建议早期干预切除CMs、含铁血黄素环和癫痫灶皮质。

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