Microsurgery for subtentorial cavernous malformations in children

Objective To investigate the safety and efficacy of microsurgery in the treatment of subtentorial cavernous malformations (CMs) in children. Methods From June 2015 to June 2018, 12 patients (14 lesions) with pathologically proven subtentorial CMs at Department of Neurosurgery, the Children′s Hospital, Zhejiang University School of Medicine, were retrospectively enrolled into this study. The lesions were located in the brainstem in 4 cases and cerebellum in 8 cases (2 of them have 2 lesions in each). The brainstem lesions were examined by diffusion tensor imaging before operation. The safety and effectiveness of the operation were evaluated based on imaging examination, improvement of nervous system symptoms and modified Rankin scale (mRS). Results Of the 14 lesions, 13 were totally resected and 1 was followed up. During hospitalization, 9 of 12 cases with preoperative symptoms were improved, 2 cases kept preoperative symptoms and 1 case died. No new neurological deficits occurred. Eleven cases were followed up for 3 to 34 months. No re-bleeding or recurrence was found in the primary site of the lesion. The mRS scores were 0 in 9 cases, 1 in 1 and 2 in 1. Conclusion Under the premise of safety, surgical treatment of children′s subtentorial CMs is effective. Key words: Hemangioma, cavernous; Central nervous system; Microsurgery; Child; Subtentorial