Management of brain stem cavernomas in setting of multiple intracranial cavernomas (a retrospective analysis of single institutional experience).

Alaswad, Mohammed Mohammed Mahmoud; Alobaid, Abdulla Omar; Elkholy, Ahmed R; Orz, Yasser; Al Yamany, Mahmoud; Bafaqeeh, Mohammed Saeed; Alzahrani, Gmaan A; Sallam, Ahmed M.; Alwably, Abdulnasser Abdullah; Jamous, Shaimaa Tawfik; Shaheen, Rakan S. N; Hallak, Hana

doi:10.21608/pajn.2024.300038.1135

Management of brain stem cavernomas in setting of multiple intracranial cavernomas (a retrospective analysis of single institutional experience).

Document Type : Original Articles

Authors

¹ neurosurgery, Ismailia Suez canal university , Ismailia , Egypt

² Neurosurgery consultant, king Fahad medical city, national neuroscience institute, Riyadh, Kingdom of Saudi Arabia

³ Faculty of Medicine-Tanta University-31527 Tanta

⁴ Neurosurgery assistant consultant, king Fahad medical city, national neuroscience institute, Riyadh, Kingdom of Saudi Arabia

⁵ College of Medicine, Dar Al-uloom University, Riyadh, Kingdom of Saudi Arabia

⁶ MBBS‏, medical intern , Riyadh, Kingdom of Saudi Arabia

⁷ College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia

⁸ MBBS ,KFSHRC, Riyadh, Saudi Arabia

10.21608/pajn.2024.300038.1135

Abstract

ABSTRACT
BACKGROUND
Cavernomas in the brain stem are associated with higher hemorrhagic rates. Several studies pressed on the surgical techniques, safety and outcome results of brain stem cavernomas. In this study, we tried to find the effect of multiple cerebral cavernomas on management of brain stem cavernomas.
OBJECTIVES
To describe our institutional experience in managing the brain stem cavernomas in setting of multiple cerebral cavernomas.
METHODS
Using retrospective analysis for the patients who have brain stem cavernomas , older than 18 years old and at least 2 years follow up , we divided them into two groups: The (non- concomitant) group (brain stem cavernomas only) and the (concomitant) group (brainstem and non-brain stem cavernomas). . Comparative study was conducted using the demographic criteria, clinical and radiological data, management strategy, cavernomas bleeding difference rates between two groups and its effect on outcome
RESULTS
Patients were divided into two groups: concomitant group (n= 21) (48.8%)) and non-concomitant group (n= 22) (51.2%)). Radiological types according to modified zabramski classification, the hemorrhagic types are IA, IB, II which accounts for 6 (27.3%) in non-concomitant group, and 15 (71.4%) in concomitant group. (χ2= 8.384, p value 0.004). Outcome using Modified Rankin Scale showed no difference between two group’s outcome neither on presentation nor after a minimum of 2 years (u=199.500, p= 0.397) and (u=180.500, p=0.145 respectively).
CONCLUSION
We concluded that the Multiplicity of cerebral cavernomas carries a statistically significant risk for hemorrhagic presentation in brain stem cavernoms.

Keywords