Publication year: 2012
Source: World Neurosurgery, Available online 26 January 2012
Da Li, Junting Zhang, Shuyu Hao, Jie Tang, Xinru Xiao, ...
ObjectiveResection of thalamic cavernous malformations (CMs) is controversial. The goals of this study were to evaluate the outcome of thalamic CMs after surgical resection, assess predictors of prognosis and review the literature.MethodsThe authors used the modified Rankin Scale (mRS) to retrospectively evaluate the presentation, surgery and outcomes of 27 consecutive patients who underwent thalamic CMs micro-resection using six different approaches between 1998 and 2010.ResultsForty-eight hemorrhages occurred in 27 patients (13 male, 14 female with a mean age 33.9 years) with a preoperative mRS score of 2.6±1.0 and a preoperative bleeding rate per patient year of 5.2%. Complete resection was achieved in 26 patients (96.3%) without surgical mortality. The postoperative mRS score at discharge was 1.9±1.0. One lesion rebled one month after complete surgical resection. After a mean follow-up duration of 48.7±43.2mo, the mean mRS score was 1.2±1.2, the postoperative rebleeding rate was 0.91% per patient year. With regard to neurological function, 81.5% of patients improved, 11.1% stabilized and 7.4% worsened. Good outcomes (mRS score≤2, living independently) were achieved in 21 patients (77.8%). Long-term surgical morbidity was observed in 5 patients (18.2%). A multivariate logistic regression analysis identified age (<40) as the only predictor of the postoperative mRS score (≤2) (odds ratio, 1.24, 95% confidence interval, 1.02-1.52;P= 0.035).ConclusionTo the best of our knowledge, this is the largest case series reported in the literature to date. Patients with thalamic CMs can obtain a favorable prognosis using microsurgery; an appropriate microsurgical approach contributes to an excellent outcome.
Source: World Neurosurgery, Available online 26 January 2012
Da Li, Junting Zhang, Shuyu Hao, Jie Tang, Xinru Xiao, ...
ObjectiveResection of thalamic cavernous malformations (CMs) is controversial. The goals of this study were to evaluate the outcome of thalamic CMs after surgical resection, assess predictors of prognosis and review the literature.MethodsThe authors used the modified Rankin Scale (mRS) to retrospectively evaluate the presentation, surgery and outcomes of 27 consecutive patients who underwent thalamic CMs micro-resection using six different approaches between 1998 and 2010.ResultsForty-eight hemorrhages occurred in 27 patients (13 male, 14 female with a mean age 33.9 years) with a preoperative mRS score of 2.6±1.0 and a preoperative bleeding rate per patient year of 5.2%. Complete resection was achieved in 26 patients (96.3%) without surgical mortality. The postoperative mRS score at discharge was 1.9±1.0. One lesion rebled one month after complete surgical resection. After a mean follow-up duration of 48.7±43.2mo, the mean mRS score was 1.2±1.2, the postoperative rebleeding rate was 0.91% per patient year. With regard to neurological function, 81.5% of patients improved, 11.1% stabilized and 7.4% worsened. Good outcomes (mRS score≤2, living independently) were achieved in 21 patients (77.8%). Long-term surgical morbidity was observed in 5 patients (18.2%). A multivariate logistic regression analysis identified age (<40) as the only predictor of the postoperative mRS score (≤2) (odds ratio, 1.24, 95% confidence interval, 1.02-1.52;P= 0.035).ConclusionTo the best of our knowledge, this is the largest case series reported in the literature to date. Patients with thalamic CMs can obtain a favorable prognosis using microsurgery; an appropriate microsurgical approach contributes to an excellent outcome.
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