Cavernoma of the central nervous system: Surgical experience in the magnetic resonance imaging era

Cavernoma, also known as cavernous hemangioma or cavernous malformation, is the most commonly found symptomatic angiographically occult vascular malformation in the central nervous system of the magnetic resonance imaging era. There were 35 cases of pathology proved central nervous system cavernomas treated in the National Taiwan University Hospital from 1985 to 1996. Of the 35 cases, 26 (74%) occurred in the intracranial space and 9 (26%) occurred in the intraspinal space. Of the 26 cases in the intracranial space, twenty-two were intraaxial and four were extraaxial. Of the four extraaxial cases, one was in the cerebellopontine angle, two were in the optic pathway, and one was in the cavernous sinus. Clinically, ten (29%) patients presented with seizure, twenty-one (60%) patients presented with hemorrhage and four (11%) patients presented with focal neurological deficits such as cranial nerve palsy. Surgical outcome of the patients with seizure in the present series is generally good. Eight cases obtained complete remission, one had residual episodes of seizure but rather minor, and one showed no improvement. There were four immediately postoperative complications and two cases had serious long term morbidity. Most of the immediate postoperative complications improved after few months. There were nine cases of cavernoma in the intraspinal space. Of the nine cases, two were in the epidural space and seven were intramedullary. All these nine cases had favorable outcome after the surgery.