Thalamic cavernous XXXX .

@entity1 @entity1276 @entity428 @entity548 @entity16 @entity600 @entity51 @entity9479 @entity1410 @entity1211 @entity1779
BACKGROUND: Only few anecdotal reports and small series of thalamic cavernous @entity600 have been reported. It follows that the clinical behavior and management are poorly understood; in particular, experiences with the surgical treatment of these lesions are scarce. METHODS: The clinical course, treatment, and outcome of 12 @entity1 (10 females and 2 males, mean age 36 years) with symptomatic cavernous @entity600 of the thalamus are reviewed. Eight @entity1 (66%) presented with @entity1779 , one with progressive @entity51 and three with @entity1276 / @entity428 ; associated @entity1211 were found in three cases. Treatment consisted of radical surgery in four cases with progressive @entity16 or recurrent disabling @entity548 , radiosurgery (one case), evacuation of a chronic satellite @entity1410 (one case), ventriculoperitoneal shunt for @entity1276 (one case) and observation (five cases). Operative treatment in four cases included transcallosal, trigonal, and occipital interhemispheric approaches. RESULTS: In the surgical group, one @entity1 died, two improved after operation, and one remained the same. Of the @entity1 not operated on radically, one had recurrent @entity548 4 months after radiosurgery, one remains stable 8 years after ventriculoperitoneal shunt, and one 3 years after aspiration of a satellite @entity1410 . Five other @entity1 presenting with @entity548 were treated conservatively; recurrent @entity548 occurred in two cases at 1 month and at 2 years, leaving a mild residual deficit in both cases. Overall, rehemorrhage occurred in four cases (50%) at a mean interval of 18 months after the first @entity548 ; the annual @entity548 rate was 6.1%. CONCLUSIONS: @entity9479 are more likely to be symptomatic from small @entity548 compared with lesions in the cerebral hemispheres; progressive growth may also occur with third ventricle invasion or caudal extension to the midbrain. Their high-risk location deters heavy-handed management, but they should not be left long untreated. Both surgery and radiosurgery have been used in the management of thalamic cavernomas reported in the literature. Definite surgical indications include progressive @entity16 and recurrent @entity548 abutting the ventricular surface or the posterior incisural space; the complex anatomy of the deep venous system and the association with unexpected @entity1211 complicates the removal of these lesions.
