REVIEW
Introdução: Os cavernomas intracranianos supratentoriais (CIS) são lesões vasculares congênitas de baixo fluxo. Sua prevalência estimada é de aproximadamente 0,16-0,9%. A ressecção cirúrgica dos CIS, principalmente em áreas eloquentes, apresenta grande desafio operatório, repleto de complicações significativas. O uso de novas tecnologias procedimentais auxiliares se mostra como de grande valia nesses casos. Métodos: Selecionamos e comparamos os dados de dez diferentes trabalhos com enfoque, além do tema CIS, nas informações apresentadas em nossa casuística, de 22 pacientes, e apresentamos os resultados de maneira sistematizada, da seguinte maneira: manifestações clínicas, abordagem cirúrgica e complicações pós-operatórias. Resultados: Respectivamente, 44% (10/22) e 34% (7/22) apresentaram cefaleia e sangramento intracraniano como manifestação inicial. A abordagem pterional (72%) foi a principal técnica realizada para ressecção de CIS em nosso trabalho. A principal complicação pós-operatória foram as crises convulsivas transitórias (18%). Conclusão: Os CIS possuem diferentes formas de apresentação clínica pela vasta abrangência de territórios corticais e subcorticais. O aprimoramento de técnicas cirúrgicas com o avanço da tecnologia minimiza as complicações pós-cirúrgicas, encorajando a sua ressecção completa com baixa morbimortalidade.
Introduction: Supratentorial intracranial cavernomas (IUS) are low-flow congenital vascular lesions. The estimated prevalence is approximately 0.16-0.9%. Surgical resection of the CIS, especially in eloquent areas, presents a great operative challenge, full of significant complications. In these cases, the use of new auxiliary procedural technologies has shown to be of great value. Methods: Data was selected and compared from ten different studies whose focus was on the CIS issue besides the information presented in our sample of 22 patients, and showed the results in a systematized manner, as follows: clinical manifestations, surgical approach and postoperative complications. Results: 44% (10/22) and 34% (7/22) presented headache and intracranial bleeding as an initial manifestation, respectively. The pterional approach (72%) was the main technique performed for CIS resection in our study. The main postoperative complication was transient seizures (18%). Conclusion: The CIS present different forms of clinical presentation seen from a wide range of cortical and subcortical territories. The improvement of surgical techniques with the advancement of the technology minimizes post-surgical complications, encouraging its complete resection with low morbidity and mortality.
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1 MD, Department of Neurosurgery Londrina Evangelic Hospital.
2 MD, MSc, Neurosurgeon, Assistant Professor, School of Medicine, Pontifical Catholic University of Parana (PUCPR); Rehabilitation Research Laboratory University of Northern Parana (UNOPAR);N3 Clinic Neurology, Neurosurgery and Pediatric Neurology; Londrina-PR, Brazil.
3 Medical Student, School of Medicine, Pontifical Catholic University of Parana (PUCPR), Londrina-PR, Brazil.
Received Jul 22, 2022
Accepted Aug 9, 2022
