Intraoperative MRI with integrated functional neuronavigation-guided resection of supratentorial cavernous malformations in eloquent brain areas

摘要: Between March 2009 and January 2010, 36 patients with 38 supratentorial cavernous malformations in eloquent brain areas underwent surgery the aid of intraoperative MRI (iMRI), functional neuronavigation, electrocorticography (ECoG). To optimize outcomes, hemosiderin-stained tissue surrounding lesion addition to malformation itself (lesion) was microsurgically removed, leaving behind only small adjacent to, or overlapping with, areas. According Zabramski classification, there were 13 type I lesions, which all total resection. There 25 II III lesions a hypointense rim, these completely removed; rims removed 15 partially 10. No new neurologic disorders occurred postoperatively. Twenty had preoperative epileptic seizures, nine whom refractory treatment. During follow-up, seizure outcome assessed using Engel 11 non-refractory epilepsy class outcome. Of epilepsy, seven (77.8%) outcome, one (11.1%)