Historia natural de 30 casos de cavernomas: un seguimiento de dos décadas en el Estado de Paraíba, Brasil

Abstract

Introduction: Cavernomas are low-flow vascular malformations that occur primarily in the brain and, less frequently, in the spinal cord. They are rare lesions and represent about 5 to 13% of vascular malformations of the central nervous system. Objectives: To evaluate the follow-up of patients diagnosed with cavernous malformations and to describe the clinical, epidemiological, topographical, evolutionary and therapeutic findings over a period of 22 years. Methodology: We present a cross-sectional, observational, quantitative study with data from 30 patients diagnosed with cavernous malformations, requiring clinical or surgical
approach, at the Neurosurgery Services of several Hospitals of João Pessoa, state of Paraíba, Brazil, during the period between 1995 and 2017. Results: The most common clinical manifestations were seizures, present in 33.33% of cases (n = 10); headache, in 20% (n= 6) and cranial nerve palsy, in 20% (n = 6). 63.33% of the patients (n = 19) were female and 36.66% (n = 11) were male. As to location, the supratentorial region predominated (70.73%) and the frontal lobe was the most affected site (41.46%). Multiple lesions occurred in three cases, of which two were confirmed cases of familial cavernoma. Of the 30 patients, 12 underwent surgery due to significant symptomatology or to the presence of complications. There was one death,
due to acute subdural hematoma. Conclusion: Cavernomas usually show a benignant behaviour, requiring surgical treatment only in symptomatic cases or in the presence of complications. Follow-up revealed a good evolution of the condition, since the majority of the patients were asymptomatic or had its symptoms controlled by medications.