海绵状血管畸形与癫痫的研究_1课件.ppt

Mean follow-up varied between 107 and 137 months for the three groups. Seizure freedom ； in DRE was 88%, in chronic epilepsy 80%, in sporadic seizures was 91%. Longer symptom duration was associated with worse seizure outcome. Significance Surgical therapy of CCM-associated seizures and epilepsy can be successful if different surgical techniques according to presurgical evaluation arerealized. To prevent clinical worsening into DRE, surgical intervention in CCM-associated epilepsy may be considered early. 发病率等 Cerebral cavernous Malformations (CCMs) account for 10–15% of all vascular malformations in the adult brain (Batra et al., 2009). The incidence of CCMs is thought to range between 0.4% and 0.8% (Del Curling et al., 1991). Forty percent to 70% of patients who have supratentorial CCM present with epilepsy (Awad Jabbour, 2006; Ferrier et al., 2007). 发病率 Seizures most probably result from various effects of blood breakdown products in the perilesional cortical area。 The epileptogenicity of CCM is influenced by its localization, particularly archicortical or temporal lobe localization (Menzler et al., 2010). 手术问题 There are two main causes to consider resection of symptomatic CCM: to prevent renewed symptomatic hemorrhage, which can cause persistent neurologic deficits,and to cure structural DRE. Seizure outcome after epilepsy surgery can be favorable in patients with single supratentorial CCMs compared with conservative treatment with antiepileptic drugs (AEDs) or other treatment modalities like irradiation (Robinson et al.,1991; Shih Pan, 2005; Hsu et al., 2007). Microsurgical removal of CCM is a well-established treatment both for cases with sporadic seizures and for chronic and/or DRE. Up to date there is still debate if the surgical removal of the hemosiderotic rim around the CCM is making seizure outcome more favorable. Cases of DRE require epilepsy surgery, which normally includes carefully presurgical epileptologic evaluat