XXXX and cavernous malformations: surgical strategies and long-term outcomes.

@entity1 @entity3877 @entity410 @entity548 @entity75 @entity51 @entity5380 @entity1315 @entity302
OBJECTIVE: @entity5380 ( @entity5380 ) of the temporal lobe often present with @entity410 . Surgical resection of these lesions can offer durable @entity410 control. There is, however, no universally accepted methodology for assessing and surgically treating these @entity1 . We propose an algorithm to maximize positive surgical outcomes ( @entity410 control) while minimizing post-surgical @entity51 . METHODS: A retrospective review of 34 @entity1 who underwent @entity302 surgery for radiographically proven temporal lobe @entity5380 was conducted. @entity1 underwent a relatively standard work-up for @entity410 localization. In @entity1 with @entity1315 ( @entity1315 ), a complete resection of the epileptogenic zone was performed including amygdalo-hippocampectomy in addition to a lesionectomy if not contraindicated by pre-operative work-up. @entity1 with neocortical @entity302 underwent intraoperative electrocorticography (ECoG)-guided lesionectomy. RESULTS: @entity410 -free rate for mesial and neocortical (anterior, lateral, and basal) location was 90 vs. 83  %, respectively. Complete resection of the lesion, irrespective of location, was statistically significant for @entity410 control (p   =   0.018). There was no difference in @entity410 control based on disease duration or location (p   >   0.05). @entity1 with mesial temporal @entity5380 who presented with @entity1315 were presumed to also have @entity3877 ( @entity3877 ), or dual pathology. These @entity1 underwent routine resection of the mesial structures. Interestingly, @entity1 who had @entity1315 and basal (neocortical) lesions who underwent a mesial resection for suspected @entity3877 were found not to have dual pathology. CONCLUSIONS: @entity1 with temporal lobe @entity5380 should be offered resection for durable @entity410 control, prevention of secondary epileptogenic foci, and elimination of @entity548 risk. The preoperative work-up should follow a team approach. Surgical intervention should include complete lesionectomy in all cases. Intra or extra-operative ECoG for @entity75 may be beneficial. Management of mesial temporal CCMs (archicortex) should consider resection of a well-defined epileptogenic zone (including mesial structures) due to high probability of pathologically proven @entity3877 . The use of this treatment algorithm is useful for the education and treatment of these @entity1 .
