Se analiza la presentación clínica y radiológica en 16 pacientes portadores de cavernomas sintomáticos del tronco cerebral y cerebelo, la mayoría de los cuales fueron estudiados con resonancia magnética. Un total de 11 pacientes que sufrieron uno o más episodios hemorrágicos fueron intervenidos quirúrgicamente. En todos los casos excepto en uno se logró la exeresis total de la lesión, pero dos pacientes tuvieron que ser reintervenidos tras una supuesta extirpación total inicial. Sólo dos pacientes experimentaron incremento definitivo, si bien discreto, de sus síntomas preoperatorios. Cinco pacientes con presentación clínica benigna están siendo tratados conservadoramente. Se comenta la indicación quirúrgica en relación con estas lesiones.
The authors analyze the clinical and radiological presentation of symptomatic cavernomas of the brain stem and cerebellum in 16 patients. The majority of the patients were studied with magnetic resonance. Eleven patients suffered one or more hemorrhagic episodes before undergoing surgical treatment. A total excision of the lesion was performed in all the 11 cases, except in one. However, 2 patients had to be reoperated after having an apparently radical removal at initial operation. There was no mortality and only 2 patients developed discrete postoperative increment in neurological deficits. Five more patients presenting with benign, self-limited symptoms are being managed conservatively. The surgical management and indications in patients with brain stem and cerebellar cavernomas are discussed.
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