Analysis Of The Effect Of Surgery And Prognosis Of Brainstem Cavernous Hemangioma

OBJECTIVE:To evaluate the surgical results and outcomes of brainstem cavernomas.METHODS:A retrospective analysis of 72 cases between 1992 and 2008 was performed, of which 55 received surgery and 17 conservatively followed for a mean 49 months. Factors that potentially influenced surgical results and outcomes such as age, sex, time of hemorrhage(s) and interval between the latest hemorrhage and surgery were recorded as well as the presenting symptoms and neurological evaluation scores for each individual during the latest episode of hemorrhage, upon admission, upon discharge and during follow-up.RESULTS:The overall hemorrhage rate and rehemorrhage rate were 4.7% and 32.7% respectively, After a mean 49 months of follow-up, NIHSS scoring improved from 4.6 to 1.4.8 patients aggravated while 44 stabilized or improved. All factors (age, sex, number of hemorrhage episodes) but depth of lesion and surgical timing did not seem to correlate with outcome. The conservatively treated patients followed for a mean 40 months also showed improvement overtime. NIHSS scores decreased from 5.9 to 1.7CONCLUSION:Surgical indications and timing, along with individualized surgical approach for each patient and precise intraoperative mapping of the cranial nerve nuclei and tracts are all essential to a better outcome for surgery. NIHSS is useful in the evaluation of neurological changes and surgical outcomes for BSCM patients.