Хірургічне лікування субтенторіальних каверном головного мозку

Abstract

To assess the effectiveness of neurosurgical treatment and develop the indications for surgery of brainstem and cerebellum cavernomas. Materials and Methods. Overall 38 patients with brainstem and cerebellar cavernomas were operated on in three neurosurgical departments from 2008 to 2015. 30 patients (78.9%) had 1 hemorrhage previous to surgery, 7 patients (18.4%) had 2 hemorrhages, and 1 patient had 3 (2.6%). The neurological status of the patients was recorded on admission, next day after surgery and on discharge. Patients were scored on Glasgow outcome scale at last follow-up visit. Results. Totally, 42 surgeries had been performed in 38 patients. In the half of cases (52.6%) neurological deficit worsened next day after surgery, but on discharge the majority of patients improved neurologically or were stable (33 (86.8%)patients). On last follow-up visit patients were scored on Glasgow outcome scale: GOS V — 33 patients (89.2%), GOS ІV — 3 patients (8.1%), GOS ІІІ — 1 patient (2.7%), GOS І та ІІ — none (0%). One patient was lost to follow-up. Patients who deteriorated neurologically on discharge were GOS III and IV on last follow-up, all of them had two haemorrhages preoperatively. Conclusions. surgical treatment of brainstem and cerebellar cavernomas is effective and safe. The resection of cavernoma should be performed after first haemorrhage in its sub-acute stage.