PMID- 23860150
OWN - NLM
STAT- MEDLINE
DCOM- 20130911
LR  - 20130717
IS  - 0028-3886 (Print)
IS  - 0028-3886 (Linking)
VI  - 61
IP  - 3
DP  - 2013 May-Jun
TI  - Extended resection of hemosiderin fringe is better for seizure outcome: a study 
      in patients with cavernous malformation associated with refractory epilepsy.
PG  - 288-92
LID - 10.4103/0028-3886.115070 [doi]
AB  - BACKGROUND: Cerebral cavernous malformation (CCM) is frequently associated with 
      intractable focal epilepsy. Epileptogenicity is usually attributed to the 
      hemosiderin deposits. Extent of resection is a crucial issue for achieving good 
      seizure outcome. AIM: To assess whether seizure outcome is related to the 
      extended resection (ER) of surrounding hemosiderin fringe brain tissue. MATERIALS 
      AND METHODS: Between April 2000 and April 2008, 132 patients with CCM and 
      refractory epilepsy were scheduled for surgery based on the high-resolution 
      magnetic resonance imaging (MRI) findings and intensive 
      video-electroencephalogram (EEG) monitoring. All patients underwent pre- and 
      post-operative MRI. Based on MRI findings patients were grouped into: ER group 
      (ER, hemosiderin completely removed) and lesionectomy group (LE, hemosiderin 
      not/partially removed). Post-operative seizure outcome was compared between the 
      two groups based on Engel and the International League Against Epilepsy outcome 
      scales. RESULTS: At 1-year follow-up of the 86 patients in the ER group, 54 
      (74.4%) achieved seizure free outcome and in the LE group of the 46 patients, 20 
      (59.5%) achieved seizure-free outcome. At 5-year follow-up, 59.5% (25/42) of 
      patients in ER group and 27.8% (5/18) of patients in LE group achieved 
      seizure-free outcome. ER was not associated with increased neurological 
      morbidity. CONCLUSIONS: Our study suggests that complete removal of hemosiderin 
      fringe brain tissue surrounding CCMs may improve short-term and long-term seizure 
      outcome.
FAU - Wang, Xiaoyu
AU  - Wang X
AD  - Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu 
      610041, Sichuan, PR China.
FAU - Tao, Zhang
AU  - Tao Z
FAU - You, Chao
AU  - You C
FAU - Li, Qiang
AU  - Li Q
FAU - Liu, Yi
AU  - Liu Y
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - India
TA  - Neurol India
JT  - Neurology India
JID - 0042005
RN  - 9011-92-1 (Hemosiderin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Electroencephalography
MH  - Female
MH  - Follow-Up Studies
MH  - Hemangioma, Cavernous, Central Nervous System/complications/*surgery
MH  - *Hemosiderin
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Neurosurgical Procedures/*methods
MH  - Seizures/etiology/*surgery
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/07/19 06:00
MHDA- 2013/09/12 06:00
CRDT- 2013/07/18 06:00
PHST- 2013/07/18 06:00 [entrez]
PHST- 2013/07/19 06:00 [pubmed]
PHST- 2013/09/12 06:00 [medline]
AID - ni_2013_61_3_288_115070 [pii]
AID - 10.4103/0028-3886.115070 [doi]
PST - ppublish
SO  - Neurol India. 2013 May-Jun;61(3):288-92. doi: 10.4103/0028-3886.115070.