Predictors of Epileptic Seizures and Ability to Work in Supratentorial Cavernous Angioma Located Within Eloquent Brain Areas
Marc Zanello
(1, 2)
,
John Goodden
(3)
,
Henry Colle
(4)
,
Michel Wager
(5)
,
Philip Hamer
(6)
,
Anja Smits
(7, 8)
,
Lorenzo Bello
(9)
,
Matthew Tate
(10)
,
Giannantonio Spena
(11)
,
Damien Bresson
(12)
,
Laurent Capelle
(13)
,
Santiago Gil Robles
(14)
,
Silvio Sarubbo
(15)
,
Bertil Rydenhag
(16)
,
Juan Martino
(17)
,
Bernhard Meyer
(18)
,
Denys Fontaine
(19)
,
Nicolas Reyns
(20)
,
Christian Schichor
(21)
,
Philippe Metellus
(22)
,
David Colle
(23)
,
Erik Robert
(24)
,
Bonny Noens
(23)
,
Peter Muller
(25)
,
Marco Rossi
(9)
,
Marco Conti Nibali
(9)
,
Costanza Papagno
(26)
,
Lara Galbarritu
(27)
,
Edurne Ruiz de Gopegui
(27)
,
Franco Chioffi
(15)
,
Carlos Bucheli
(17)
,
Sandro M Krieg
(28)
,
Maria Wostrack
(28)
,
Natan Yusupov
(21)
,
Victoria Visser
(6)
,
Johannes Baaijen
(6)
,
Alexandre Roux
(1, 2)
,
Edouard Dezamis
(29, 2)
,
Emmanuel Mandonnet
(7)
,
Robert Corns
(3)
,
Hugues Duffau
(30)
,
Johan Pallud
(1, 29, 2)
1
Centre Hospitalier Sainte Anne [Paris]
2 U894 - Centre de Psychiatrie et Neurosciences
3 LGI - Leeds General Infirmary
4 Department of Neurosurgery
5 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
6 VU University Medical Center [Amsterdam]
7 Sahlgrenska Academy at University of Gothenburg [Göteborg]
8 Uppsala University Hospital
9 Humanitas Clinical and Research Center [Rozzano, Milan, Italy]
10 Feinberg School of Medicine
11 Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia [Brescia]
12 Hôpital Lariboisière-Fernand-Widal [APHP]
13 CHU Pitié-Salpêtrière [AP-HP]
14 Hospital Universitario Quironsalud
15 Department of Neurosciences, Division of Neurosurgery, “S. Chiara” Hospital, Trento APSS – 9 Largo Medaglie D’Oro, Trento, 38122, Italy
16 GU - Göteborgs Universitet = University of Gothenburg
17 Hospital Universitario Marqués de Valdecilla [Santander]
18 TUM - Technische Universität Munchen - Technical University Munich - Université Technique de Munich
19 CHU Nice - Centre Hospitalier Universitaire de Nice
20 Hôpital Roger Salengro [Lille]
21 University-Hospital Munich-Großhadern [München]
22 Hôpital Privé Clairval [Marseille]
23 Department of Neurosurgery
24 Department of Neurosurgery
25 Department of Neurosurgery
26 CIMEC - Center for Mind/Brain Sciences
27 Hospital Universitario Cruces = Cruces University Hospital
28 MRI TUM - Klinikum rechts der Isar
29 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
30 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
2 U894 - Centre de Psychiatrie et Neurosciences
3 LGI - Leeds General Infirmary
4 Department of Neurosurgery
5 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
6 VU University Medical Center [Amsterdam]
7 Sahlgrenska Academy at University of Gothenburg [Göteborg]
8 Uppsala University Hospital
9 Humanitas Clinical and Research Center [Rozzano, Milan, Italy]
10 Feinberg School of Medicine
11 Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia [Brescia]
12 Hôpital Lariboisière-Fernand-Widal [APHP]
13 CHU Pitié-Salpêtrière [AP-HP]
14 Hospital Universitario Quironsalud
15 Department of Neurosciences, Division of Neurosurgery, “S. Chiara” Hospital, Trento APSS – 9 Largo Medaglie D’Oro, Trento, 38122, Italy
16 GU - Göteborgs Universitet = University of Gothenburg
17 Hospital Universitario Marqués de Valdecilla [Santander]
18 TUM - Technische Universität Munchen - Technical University Munich - Université Technique de Munich
19 CHU Nice - Centre Hospitalier Universitaire de Nice
20 Hôpital Roger Salengro [Lille]
21 University-Hospital Munich-Großhadern [München]
22 Hôpital Privé Clairval [Marseille]
23 Department of Neurosurgery
24 Department of Neurosurgery
25 Department of Neurosurgery
26 CIMEC - Center for Mind/Brain Sciences
27 Hospital Universitario Cruces = Cruces University Hospital
28 MRI TUM - Klinikum rechts der Isar
29 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
30 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
Michel Wager
- Fonction : Auteur
- PersonId : 919915
Matthew Tate
- Fonction : Auteur
- PersonId : 796902
- ORCID : 0000-0002-0206-7722
Marco Rossi
- Fonction : Auteur
- PersonId : 757527
- ORCID : 0000-0002-0196-2370
Emmanuel Mandonnet
- Fonction : Auteur
- PersonId : 755112
- ORCID : 0000-0003-0230-9282
- IdRef : 100933157
Hugues Duffau
- Fonction : Auteur
- PersonId : 756310
- ORCID : 0000-0002-6558-2342
- IdRef : 071504737
Johan Pallud
- Fonction : Auteur
- PersonId : 758320
- ORCID : 0000-0002-1652-9844
- IdRef : 12225225X
Résumé
The postoperative outcomes and the predictors of seizure control are poorly studied for supratentorial cavernous angiomas (CA) within or close to the eloquent brain area.
Objective: To assess the predictors of preoperative seizure control, postoperative seizure control, and postoperative ability to work, and the safety of the surgery.
Methods: Multicenter international retrospective cohort analysis of adult patients benefitting from a functional-based surgical resection with intraoperative functional brain mapping for a supratentorial CA within or close to eloquent brain areas.
Results: A total of 109 patients (66.1% women; mean age 38.4 ± 12.5 yr), were studied. Age >38 yr (odds ratio [OR], 7.33; 95% confidence interval [CI], 1.53-35.19; P = .013) and time to surgery > 12 mo (OR, 18.21; 95% CI, 1.11-296.55; P = .042) are independent predictors of uncontrolled seizures at the time of surgery. Focal deficit (OR, 10.25; 95% CI, 3.16-33.28; P < .001) is an independent predictor of inability to work at the time of surgery. History of epileptic seizures at the time of surgery (OR, 7.61; 95% CI, 1.67-85.42; P = .003) and partial resection of the CA and/or of the hemosiderin rim (OR, 12.02; 95% CI, 3.01-48.13; P < .001) are independent predictors of uncontrolled seizures postoperatively. Inability to work at the time of surgery (OR, 19.54; 95% CI, 1.90-425.48; P = .050), Karnofsky Performance Status ≤ 70 (OR, 51.20; 95% CI, 1.20-2175.37; P = .039), uncontrolled seizures postoperatively (OR, 105.33; 95% CI, 4.32-2566.27; P = .004), and worsening of cognitive functions postoperatively (OR, 13.71; 95% CI, 1.06-176.66; P = .045) are independent predictors of inability to work postoperatively.
Conclusion: The functional-based resection using intraoperative functional brain mapping allows safe resection of CA and the peripheral hemosiderin rim located within or close to eloquent brain areas.