ArticleLangenbeck's archives of surgery2025
Predictors of postoperative epileptic seizures after microsurgical treatment in supratentorial single cerebral cavernous malformations: a retrospective study.
Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSeizures are the most common symptom of supratentorial cerebral cavernous malformations (CCMs). This study aimed to investigate the predictors of seizure freedom in patients with single supratentorial CCMs after microsurgical treatment.
methodsClinical data were retrospectively obtained from 164 patients with CCM (including 98 patients with preoperative seizures, and 66 patients without preoperative seizures) who underwent microsurgical treatment between January 2016 and December 2023 at the First Affiliated Hospital of Sun Yat-sen University.
resultsAfter microsurgical treatment, early postoperative seizures (≤ 1 week) occurred in 2 of 98 (2.04%) and 2 of 66 (3.03%) CCM patients with and without preoperative seizures, respectively. The mean length of follow-up for all the patients was 44.70 ± 2.04 months (range: 1-98 months). Sixty-four of the 66 (96.97%) patients without preoperative seizures were seizure free during the follow-up period. Among the patients with preoperative seizures, 77 of 98 (78.57%) patients achieved followed-up seizure remission, including 18 of 28 (64.29%) patients with drug-resistant epilepsy and 59 of 70 (84.29%) patients with drug-controlled epilepsy. Univariate analysis indicated that preoperative seizure duration, drug-resistant epilepsy, tailored resection and the application of intraoperative electrocorticography (ECoG) were important risk factors that affected followed-up seizure remission among patients with preoperative seizures. However, according to multivariate regression, only the use of intraoperative ECoG was an independent predictor related to the followed-up seizure remission.
conclusionFor CCM patients with preoperative seizures, intraoperative ECoG was an independent predictor of followed-up seizure remission. The application of intraoperative ECoG is beneficial for improving seizure outcome among CCM patients after microsurgical treatment, especially among patients with preoperative drug-resistant epilepsy.
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