Turkish Neurosurgery
Analysis of Cavernous Malformations: Experience with 18 Cases
Ersin Hacıyakupoğlu1, Derviş Mansuri Yılmaz2, Burak Kınalı3, Tuğana Akbaş4, Sebahattin Hacıyakupoğlu5
1Klinik für Wirbelsaulen , Chirurgie und Neurotraumatologie, Zwickau,
2Cukurova University, School of Medicine, Neurosurgery Department, Adana,
3Health Science University Tepecik Training and Research Hospital, Neurosurgery Department, İzmir,
4Acibadem University School of Medicine, Department of Radiology, Adana,
5Acibadem University School of Medicine, Department of Neurosurgery, Adana,
DOI: 10.5137/1019-5149.JTN.22645-18.2

Aim: To analyse the results of stereotactic radiosurgery and/or surgical treatment of 18 cases with cavernous malformation and report 2 cases with unusual localisation and size. Material and Methods: We present 11 cases who underwent operation and 8 cases who underwent stereotactic radiosurgery between 2010-2018.The operated group consisted of 6 male, 5 female with a mean age of 33.6. We applied SRS to 5 male, 3 female with a mean age of 33.3. All the cases were diagnosed and followed up with Magnetic Resonance Imaging. Stereotactic navigation was not used for localisation of the lesion. We excised the lesion including the area with hemosiderin easily by microsurgical approach. Results:Except recurrent headache all the symptoms of the patients who were operated recovered rapidly. Hemorrhage developed in 2 of our cases followingstereotactic radiosurgery, one of them refused operation and recovered completely with steroid therapy. The other case underwent operation following the detection cavernous malformation at the posterior fossa reaching a dimension of 26,8x26,2 mm and occluding 4th ventricle.Conclusion:Surgical excision is the gold standart of treatment in cases without significant preoperative morbidity risk. Stereotactic radiosurgery is applied in surgically inaccessible, deep located, multiple cavernous malformations at brain stem and elequent area. If basal size of giant cavernous malformation is accepted as 2.5cm like giant aneurysm, up to our knowledge our case will be the first giant cavernous malformation at the posterior fossa.

Corresponding author : Derviş Mansuri Yılmaz