Efficacia del trattamento chirurgico nella riduzione delle crisi epilettiche negli angiomi cavernosi

The authors presents a retrospective clinical study about the postoperative seizure's outcome in patients operated on for cavernous cerebral angioma. From 1990 to 2001, 90 patients were discharged, after surgery for cavernous angioma at the "UO Neurochirurgia" of the "Policlinico Hospital" of Milan and "UO Neurochirurgia" of the "San Gerardo Hospital" of Monza. 67 were followed up. The follow-up ranged from 1 to 12 years (mean 6,6yrs). 33 patients were male and 34 female. At the time of surgery patient mean age was 34.9 yrs. The cerebral location of the vascular malformation was frontal in 25 pt, temporal in 24 pt, parietal in 6 pt, occipital in 1 pts, brainstem in 9 pts and in 2 cases in the cerebellum, 6 cases presented multiple angioma. 49 pt (73%) showed seizures before surgery, in 36 of these cases the seizures were well controlled by AEDs. The aim of our study is to evaluate the modification of the seizures after the removal of the angioma. The results of the study is that: 16 pts (23.8%) never showed pre or postoperative seizures, 31 pt (42.2%) stopped suffering seizures postsurgery, only 2 pts (2.9%) experienced the first seizure after treatment (both cases with multiple angioma) while 18 cases (26.8%) had persistent seizures but in 11 out of 18 pts the seizures showed significant improvement. In our opinion the removal of symptomatic cavernous angioma is able to eliminate risk of bleeding and to produce significant improvement of postoperative epileptic seizures.