Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

Marc Zanello; John R. Goodden; Henry Colle; Michel Wager; Philip C.De Witt Hamer; Anja Smits; Lorenzo Bello; Matthew Tate; Giannantonio Spena; Damien Bresson; Laurent Capelle; Santiago Gil Robles; Silvio Sarubbo; Bertil Rydenhag; Juan Martino; Bernhard Meyer; Denys Fontaine; Nicolas Reyns; Christian Schichor; Philippe Metellus; David Colle; Erik Robert; Bonny Noens; Peter Muller; Marco Rossi; Marco Conti Nibali; Costanza Papagno; Lara Galbarritu; Edurne Ruiz De Gopegui; Franco Chioffi; Carlos Bucheli; Sandro M. Krieg; Maria Wostrack; Natan Yusupov; Victoria Visser; Johannes C. Baaijen; Alexandre Roux; Edouard Dezamis; Emmanuel Mandonnet; Robert Corns; Hugues Duffau; Johan Pallud

doi:10.1093/neuros/nyz063

Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

Marc Zanello, John R. Goodden, Henry Colle, Michel Wager, Philip C.De Witt Hamer, Anja Smits, Lorenzo Bello, Matthew Tate, Giannantonio Spena, Damien Bresson, Laurent Capelle, Santiago Gil Robles, Silvio Sarubbo, Bertil Rydenhag, Juan Martino, Bernhard Meyer, Denys Fontaine, Nicolas Reyns, Christian Schichor, Philippe MetellusDavid Colle, Erik Robert, Bonny Noens, Peter Muller, Marco Rossi, Marco Conti Nibali, Costanza Papagno, Lara Galbarritu, Edurne Ruiz De Gopegui, Franco Chioffi, Carlos Bucheli, Sandro M. Krieg, Maria Wostrack, Natan Yusupov, Victoria Visser, Johannes C. Baaijen, Alexandre Roux, Edouard Dezamis, Emmanuel Mandonnet, Robert Corns, Hugues Duffau, Johan Pallud^*

^*Corresponding author for this work

Neurological Surgery

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.

Original language	English (US)
Pages (from-to)	E702-E713
Journal	Clinical Neurosurgery
Volume	85
Issue number	4
DOIs	https://doi.org/10.1093/neuros/nyz063
State	Published - Oct 1 2019

Funding

Dr Meyer declares a grant for an independent scientific project from Medtronic, Ulrich Medical, Icotec, and Relievant, declares travel grants, honoraria, and payment for Medtronic, Brainlab, Spineart, and Relievant, declares a consultancy role for Medtronic, Spineart, and Relievant, and declares royalties from Spineart. Dr Krieg declares a consultancy role for Brainlab AG (Munich, Germany) and Nexstim Plc (Helsinki, Finland). Dr Pallud declares honoraria for consultancy and speaking engagements (including travel and accommodation) from Archimedes Pharma. The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.

Keywords

Cavernous angioma
Epilepsy
Intraoperative brain mapping
Outcome
Return to work
Seizures
Surgery

ASJC Scopus subject areas

Surgery
Clinical Neurology

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10.1093/neuros/nyz063

Cite this

Zanello, M., Goodden, J. R., Colle, H., Wager, M., Hamer, P. C. D. W., Smits, A., Bello, L., Tate, M., Spena, G., Bresson, D., Capelle, L., Robles, S. G., Sarubbo, S., Rydenhag, B., Martino, J., Meyer, B., Fontaine, D., Reyns, N., Schichor, C., ... Pallud, J. (2019). Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas. Clinical Neurosurgery, 85(4), E702-E713. https://doi.org/10.1093/neuros/nyz063

@article{37aa83761f4d43da9c2ab91530cea0ca,

title = "Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas",

abstract = "BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.",

keywords = "Cavernous angioma, Epilepsy, Intraoperative brain mapping, Outcome, Return to work, Seizures, Surgery",

author = "Marc Zanello and Goodden, {John R.} and Henry Colle and Michel Wager and Hamer, {Philip C.De Witt} and Anja Smits and Lorenzo Bello and Matthew Tate and Giannantonio Spena and Damien Bresson and Laurent Capelle and Robles, {Santiago Gil} and Silvio Sarubbo and Bertil Rydenhag and Juan Martino and Bernhard Meyer and Denys Fontaine and Nicolas Reyns and Christian Schichor and Philippe Metellus and David Colle and Erik Robert and Bonny Noens and Peter Muller and Marco Rossi and Nibali, {Marco Conti} and Costanza Papagno and Lara Galbarritu and {De Gopegui}, {Edurne Ruiz} and Franco Chioffi and Carlos Bucheli and Krieg, {Sandro M.} and Maria Wostrack and Natan Yusupov and Victoria Visser and Baaijen, {Johannes C.} and Alexandre Roux and Edouard Dezamis and Emmanuel Mandonnet and Robert Corns and Hugues Duffau and Johan Pallud",

note = "Publisher Copyright: Copyright {\textcopyright} 2019 by the Congress of Neurological Surgeons.",

year = "2019",

month = oct,

day = "1",

doi = "10.1093/neuros/nyz063",

language = "English (US)",

volume = "85",

pages = "E702--E713",

journal = "Clinical Neurosurgery",

issn = "0148-396X",

publisher = "Lippincott Williams and Wilkins",

number = "4",

}

Zanello, M, Goodden, JR, Colle, H, Wager, M, Hamer, PCDW, Smits, A, Bello, L, Tate, M, Spena, G, Bresson, D, Capelle, L, Robles, SG, Sarubbo, S, Rydenhag, B, Martino, J, Meyer, B, Fontaine, D, Reyns, N, Schichor, C, Metellus, P, Colle, D, Robert, E, Noens, B, Muller, P, Rossi, M, Nibali, MC, Papagno, C, Galbarritu, L, De Gopegui, ER, Chioffi, F, Bucheli, C, Krieg, SM, Wostrack, M, Yusupov, N, Visser, V, Baaijen, JC, Roux, A, Dezamis, E, Mandonnet, E, Corns, R, Duffau, H & Pallud, J 2019, 'Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas', Clinical Neurosurgery, vol. 85, no. 4, pp. E702-E713. https://doi.org/10.1093/neuros/nyz063

TY - JOUR

T1 - Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

AU - Zanello, Marc

AU - Goodden, John R.

AU - Colle, Henry

AU - Wager, Michel

AU - Hamer, Philip C.De Witt

AU - Smits, Anja

AU - Bello, Lorenzo

AU - Tate, Matthew

AU - Spena, Giannantonio

AU - Bresson, Damien

AU - Capelle, Laurent

AU - Robles, Santiago Gil

AU - Sarubbo, Silvio

AU - Rydenhag, Bertil

AU - Martino, Juan

AU - Meyer, Bernhard

AU - Fontaine, Denys

AU - Reyns, Nicolas

AU - Schichor, Christian

AU - Metellus, Philippe

AU - Colle, David

AU - Robert, Erik

AU - Noens, Bonny

AU - Muller, Peter

AU - Rossi, Marco

AU - Nibali, Marco Conti

AU - Papagno, Costanza

AU - Galbarritu, Lara

AU - De Gopegui, Edurne Ruiz

AU - Chioffi, Franco

AU - Bucheli, Carlos

AU - Krieg, Sandro M.

AU - Wostrack, Maria

AU - Yusupov, Natan

AU - Visser, Victoria

AU - Baaijen, Johannes C.

AU - Roux, Alexandre

AU - Dezamis, Edouard

AU - Mandonnet, Emmanuel

AU - Corns, Robert

AU - Duffau, Hugues

AU - Pallud, Johan

PY - 2019/10/1

Y1 - 2019/10/1

N2 - BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.

AB - BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.

KW - Cavernous angioma

KW - Epilepsy

KW - Intraoperative brain mapping

KW - Outcome

KW - Return to work

KW - Seizures

KW - Surgery

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U2 - 10.1093/neuros/nyz063

DO - 10.1093/neuros/nyz063

M3 - Article

C2 - 30924504

AN - SCOPUS:85073452797

SN - 0148-396X

VL - 85

SP - E702-E713

JO - Clinical Neurosurgery

JF - Clinical Neurosurgery

IS - 4

ER -

Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas

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