Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers

Marc Zanello, Bernhard Meyer, Megan Still, John R. Goodden, Henry Colle, Christian Schichor, Lorenzo Bello, Michel Wager, Anja Smits, Bertil Rydenhag, Matthew Christopher Tate, Philippe Metellus, Philip De Witt Hamer, Giannantonio Spena, Laurent Capelle, Emmanuel Mandonnet, Santiago Gil Robles, Silvio Sarubbo, Juan Martino González, Denys FontaineNicolas Reyns, Sandro M. Krieg, Gilles Huberfeld, Maria Wostrack, David Colle, Erik Robert, Bonny Noens, Peter Muller, Natan Yusupov, Marco Rossi, Marco Conti Nibali, Costanza Papagno, Victoria Visser, Hans Baaijen, Lara Galbarritu, Franco Chioffi, Carlos Bucheli, Alexandre Roux, Edouard Dezamis, Hugues Duffau, Johan Pallud*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area. Method: An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area. Results: 272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control. Conclusions: We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection.

Original languageEnglish (US)
Pages (from-to)31-40
Number of pages10
JournalSeizure
Volume69
DOIs
StatePublished - Jul 1 2019

Fingerprint

Cavernous Hemangioma
Brain
Hemosiderin
Seizures
Anticonvulsants
Surveys and Questionnaires
Prospective Studies

Keywords

  • Cavernous angioma
  • Epilepsy
  • Intra-operative brain mapping
  • Outcome
  • Return to work

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Zanello, Marc ; Meyer, Bernhard ; Still, Megan ; Goodden, John R. ; Colle, Henry ; Schichor, Christian ; Bello, Lorenzo ; Wager, Michel ; Smits, Anja ; Rydenhag, Bertil ; Tate, Matthew Christopher ; Metellus, Philippe ; Hamer, Philip De Witt ; Spena, Giannantonio ; Capelle, Laurent ; Mandonnet, Emmanuel ; Robles, Santiago Gil ; Sarubbo, Silvio ; Martino González, Juan ; Fontaine, Denys ; Reyns, Nicolas ; Krieg, Sandro M. ; Huberfeld, Gilles ; Wostrack, Maria ; Colle, David ; Robert, Erik ; Noens, Bonny ; Muller, Peter ; Yusupov, Natan ; Rossi, Marco ; Conti Nibali, Marco ; Papagno, Costanza ; Visser, Victoria ; Baaijen, Hans ; Galbarritu, Lara ; Chioffi, Franco ; Bucheli, Carlos ; Roux, Alexandre ; Dezamis, Edouard ; Duffau, Hugues ; Pallud, Johan. / Surgical resection of cavernous angioma located within eloquent brain areas : International survey of the practical management among 19 specialized centers. In: Seizure. 2019 ; Vol. 69. pp. 31-40.
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title = "Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers",
abstract = "Purpose: The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area. Method: An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area. Results: 272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control. Conclusions: We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection.",
keywords = "Cavernous angioma, Epilepsy, Intra-operative brain mapping, Outcome, Return to work",
author = "Marc Zanello and Bernhard Meyer and Megan Still and Goodden, {John R.} and Henry Colle and Christian Schichor and Lorenzo Bello and Michel Wager and Anja Smits and Bertil Rydenhag and Tate, {Matthew Christopher} and Philippe Metellus and Hamer, {Philip De Witt} and Giannantonio Spena and Laurent Capelle and Emmanuel Mandonnet and Robles, {Santiago Gil} and Silvio Sarubbo and {Martino Gonz{\'a}lez}, Juan and Denys Fontaine and Nicolas Reyns and Krieg, {Sandro M.} and Gilles Huberfeld and Maria Wostrack and David Colle and Erik Robert and Bonny Noens and Peter Muller and Natan Yusupov and Marco Rossi and {Conti Nibali}, Marco and Costanza Papagno and Victoria Visser and Hans Baaijen and Lara Galbarritu and Franco Chioffi and Carlos Bucheli and Alexandre Roux and Edouard Dezamis and Hugues Duffau and Johan Pallud",
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language = "English (US)",
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journal = "Seizure : the journal of the British Epilepsy Association",
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Zanello, M, Meyer, B, Still, M, Goodden, JR, Colle, H, Schichor, C, Bello, L, Wager, M, Smits, A, Rydenhag, B, Tate, MC, Metellus, P, Hamer, PDW, Spena, G, Capelle, L, Mandonnet, E, Robles, SG, Sarubbo, S, Martino González, J, Fontaine, D, Reyns, N, Krieg, SM, Huberfeld, G, Wostrack, M, Colle, D, Robert, E, Noens, B, Muller, P, Yusupov, N, Rossi, M, Conti Nibali, M, Papagno, C, Visser, V, Baaijen, H, Galbarritu, L, Chioffi, F, Bucheli, C, Roux, A, Dezamis, E, Duffau, H & Pallud, J 2019, 'Surgical resection of cavernous angioma located within eloquent brain areas: International survey of the practical management among 19 specialized centers', Seizure, vol. 69, pp. 31-40. https://doi.org/10.1016/j.seizure.2019.03.022

Surgical resection of cavernous angioma located within eloquent brain areas : International survey of the practical management among 19 specialized centers. / Zanello, Marc; Meyer, Bernhard; Still, Megan; Goodden, John R.; Colle, Henry; Schichor, Christian; Bello, Lorenzo; Wager, Michel; Smits, Anja; Rydenhag, Bertil; Tate, Matthew Christopher; Metellus, Philippe; Hamer, Philip De Witt; Spena, Giannantonio; Capelle, Laurent; Mandonnet, Emmanuel; Robles, Santiago Gil; Sarubbo, Silvio; Martino González, Juan; Fontaine, Denys; Reyns, Nicolas; Krieg, Sandro M.; Huberfeld, Gilles; Wostrack, Maria; Colle, David; Robert, Erik; Noens, Bonny; Muller, Peter; Yusupov, Natan; Rossi, Marco; Conti Nibali, Marco; Papagno, Costanza; Visser, Victoria; Baaijen, Hans; Galbarritu, Lara; Chioffi, Franco; Bucheli, Carlos; Roux, Alexandre; Dezamis, Edouard; Duffau, Hugues; Pallud, Johan.

In: Seizure, Vol. 69, 01.07.2019, p. 31-40.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Surgical resection of cavernous angioma located within eloquent brain areas

T2 - International survey of the practical management among 19 specialized centers

AU - Zanello, Marc

AU - Meyer, Bernhard

AU - Still, Megan

AU - Goodden, John R.

AU - Colle, Henry

AU - Schichor, Christian

AU - Bello, Lorenzo

AU - Wager, Michel

AU - Smits, Anja

AU - Rydenhag, Bertil

AU - Tate, Matthew Christopher

AU - Metellus, Philippe

AU - Hamer, Philip De Witt

AU - Spena, Giannantonio

AU - Capelle, Laurent

AU - Mandonnet, Emmanuel

AU - Robles, Santiago Gil

AU - Sarubbo, Silvio

AU - Martino González, Juan

AU - Fontaine, Denys

AU - Reyns, Nicolas

AU - Krieg, Sandro M.

AU - Huberfeld, Gilles

AU - Wostrack, Maria

AU - Colle, David

AU - Robert, Erik

AU - Noens, Bonny

AU - Muller, Peter

AU - Yusupov, Natan

AU - Rossi, Marco

AU - Conti Nibali, Marco

AU - Papagno, Costanza

AU - Visser, Victoria

AU - Baaijen, Hans

AU - Galbarritu, Lara

AU - Chioffi, Franco

AU - Bucheli, Carlos

AU - Roux, Alexandre

AU - Dezamis, Edouard

AU - Duffau, Hugues

AU - Pallud, Johan

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose: The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area. Method: An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area. Results: 272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control. Conclusions: We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection.

AB - Purpose: The practical management of cavernous angioma located within eloquent brain area before, during and after surgical resection is poorly documented. We assessed the practical pre-operative, intra-operative, and post-operative management of cavernous angioma located within eloquent brain area. Method: An online survey composed of 61 items was sent to 26 centers to establish a multicenter international retrospective cohort of adult patients who underwent a surgical resection as the first-line treatment of a supratentorial cavernous angioma located within or close to eloquent brain area. Results: 272 patients from 19 centers (mean 13.6 ± 16.7 per center) from eight countries were included. The pre-operative management varied significantly between centers and countries regarding the pre-operative functional assessment, the pre-operative epileptological assessment, the first given antiepileptic drug, and the time to surgery. The intra-operative environment varied significantly between centers and countries regarding the use of imaging systems, the use of functional mapping with direct electrostimulations, the extent of resection of the hemosiderin rim, the realization of a post-operative functional assessment, and the time to post-operative functional assessment. The present survey found a post-operative improvement, as compared to pre-operative evaluations, of the functional status, the ability to work, and the seizure control. Conclusions: We observed a variety of practice between centers and countries regarding the management of cavernous angioma located within eloquent regions. Multicentric prospective studies are required to solve relevant questions regarding the management of cavernous angioma-related seizures, the timing of surgery, and the optimal extent of hemosiderin rim resection.

KW - Cavernous angioma

KW - Epilepsy

KW - Intra-operative brain mapping

KW - Outcome

KW - Return to work

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