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Neurochirurgie
Vol 53, N° 2-3-C2  - juin 2007
pp. 182-191
Doi : 10.1016/j.neuchi.2007.03.008
Received : 16 mars 2007 ;  accepted : 20 mars 2007
Cavernomes profonds (corps calleux, intraventriculaires, ganglions de la base, insulaires) et du tronc cérébral. Expérience d'une série brésilienne
Deep-seated (corpus callosum, intraventricular, basal ganglia and insula) and brain stem cavernous angiomas. Experience in Brazil
 

A. Alves de Sousa
Hôpital Santa-Casa, hôpital Lifecenter, Belo Horizonte, Brésil

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Résumé

À partir des données de la littérature, les auteurs donnent leur expérience du traitement chirurgical des cavernomes cérébraux profonds (intraventriculaires, du corps calleux, des ganglions de la base, de la capsule interne et de l'insula), et du tronc cérébral. Le traitement chirurgical concerne neuf cas de cavernomes cérébraux profonds avec une évolution favorable pour tous. Treize cavernomes du tronc cérébral ont été opérés. Neuf patients ont été stabilisés ou améliorés. Un a été aggravé, un est décédé, deux ont été perdus de vue. Quelle que soit la localisation, l'indication opératoire concerne les formes hémorragiques ou symptomatiques de cavernomes situés au contact de la surface piale ou épendymaire, ou dans une zone où le parenchyme à traverser est de faible épaisseur. La neuronavigation et la microchirurgie constituent des aides techniques indispensables.

Abstract
Abstract

With a review of the literature, we report our experience with surgical treatment of deep-seated cavernomas (intraventricular, of the corpus callosum, the capsula interna, the insula and the brain stem). Outcome was good in all nine patients after surgery for deep-seated brain cavernomas. There we also 13 cases of the brain stem cavernomas treated surgically. Of them, nine patients were stabilized or improved, one patient worsened, one patient died and two were lost to follow-up. Whatever the location, surgery should only concern symptomatic or hemorrhagic lesions close to the pia-matter or the ependyma as well as those covered by a thin layer of parenchyma. Neuronavigation and microsurgical procedures are essential in the treatment of deep-seated cavernomas.

Keywords: Deep-seated cavernomas , Surgical approach






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