TY - JOUR
T1 - Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas
AU - Zanello, Marc
AU - Goodden, John R.
AU - Colle, Henry
AU - Wager, Michel
AU - Hamer, Philip C. De Witt
AU - Smits, Anja
AU - Bello, Lorenzo
AU - Tate, Matthew
AU - Spena, Giannantonio
AU - Bresson, Damien
AU - Capelle, Laurent
AU - Robles, Santiago Gil
AU - Sarubbo, Silvio
AU - Rydenhag, Bertil
AU - Martino, Juan
AU - Meyer, Bernhard
AU - Fontaine, Denys
AU - Reyns, Nicolas
AU - Schichor, Christian
AU - Metellus, Philippe
AU - Colle, David
AU - Robert, Erik
AU - Noens, Bonny
AU - Muller, Peter
AU - Rossi, Marco
AU - Nibali, Marco Conti
AU - Papagno, Costanza
AU - Galbarritu, Lara
AU - de Gopegui, Edurne Ruiz
AU - Chioffi, Franco
AU - Bucheli, Carlos
AU - Krieg, Sandro M.
AU - Wostrack, Maria
AU - Yusupov, Natan
AU - Visser, Victoria
AU - Baaijen, Johannes C.
AU - Roux, Alexandre
AU - Dezamis, Edouard
AU - Mandonnet, Emmanuel
AU - Corns, Robert
AU - Duffau, Hugues
AU - Pallud, Johan
PY - 2019
Y1 - 2019
N2 - BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.
AB - BACKGROUND: The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area. OBJECTIVE: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery. METHODS: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas. RESULTS: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P =. 013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P =. 042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P <. 001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P =. 003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P <. 001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P =. 050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P =. 039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P =. 004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P =. 045) are independent predictors of inability to work postoperatively. CONCLUSION: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.
KW - Cavernous angioma
KW - Epilepsy
KW - Intraoperative brain mapping
KW - Outcome
KW - Return to work
KW - Seizures
KW - Surgery
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85073452797&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30924504
U2 - 10.1093/neuros/nyz063
DO - 10.1093/neuros/nyz063
M3 - Article
C2 - 30924504
VL - 85
SP - E702-E713
JO - Neurosurgery
JF - Neurosurgery
SN - 0148-396X
IS - 4
ER -