OBJECTIVE: To clinically characterize and define the natural history of a cohort of radiographically defined spinal cavernous malformations (SCM).BACKGROUND: SCM are an uncommon vascular malformation with little known of the natural history. Natural history data can be important in management decisions.DESIGN/METHODS: Consecutive patients with SCM seen at Mayo Clinic between 1996 and 2010 were retrospectively identified from a radiographic database. Extensive clinical and radiographic information were abstracted. Follow up information was obtained in 2012 by clinical chart. If not seen within 6 months of time of data abstraction, a survey was sent to patients followed by a phone call. Follow up information included recurrent symptomatic events and functional status. Symptomatic events were defined as new neurological symptoms that anatomically corresponded with the SCM. Hemorrhage was defined as symptomatic events with radiographic evidence of hemorrhage.RESULTS: Sixty-two patients with SCM were identified (35 male; average age=51.4). The SCM presented in the following manner: 10 incidentally discovered, 1 through screening due to known brain CM, 47 after symptomatic event, 4 unknown. Median follow up time was 832.5 days. Of the 10 patients with incidentally found cavernomas, none went on to have hemorrhages. Of the 47 patients presenting with symptoms associated with the cavernoma, 5 patients (10.6%) had a total of 8 symptomatic events while followed at our institution. Of the 62 patient cohort, 46 patients were followed for greater than 6 months. Three of these patients showed worsening neurological status by ASIA classification, 4 showed improvement, 30 remained stable and 9 were uncertain. Twenty two patients ultimately underwent surgical resectionCONCLUSIONS: Patients with incidentally discovered SCM had a benign clinical course, while those with symptomatic lesions showed a higher rate of recurrent events.Study Supported by:
Disclosure: Dr. Williams has nothing to disclose. Dr. Flemming has nothing to disclose. Dr. Brown has nothing to disclose.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/S25.006?rss=1
Júlio Pereira
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