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Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy.

Publication ,  Journal Article
Kraemer, DL; Griebel, ML; Lee, N; Friedman, AH; Radtke, RA
Published in: Epilepsia
June 1998

PURPOSE: This retrospective study reports the long-term surgical outcome of patients with medically refractory epilepsy and vascular malformations who were treated with lesionectomy. A detailed analysis of surgical failures had been performed in an attempt to define predictors of surgical success and failure. METHODS: Fifteen patients with medically intractable epilepsy and angiographically occult vascular malformations (AOVMs) were treated surgically with lesionectomy at Duke University Medical Center. Lesionectomy consisted of removal of the AOVM and surrounding hemosiderin-stained brain only, without the use of electrocorticography (ECoG) to guide resection. RESULTS: Eleven (73%) patients are seizure free after lesionectomy. Three showed no significant improvement, and one patient died, presumably after a seizure. Age of onset, duration of seizures, age at resection, and gender did not affect outcome. All patients with neocortical AOVMs in whom EEG findings correlated with the site of the lesion were seizure free after lesional resection. Treatment failures were associated with the presence of multiple intracranial lesions, poorly localized or diffuse EEG findings, discordant positron emission tomography (PET) imaging, or with a lesion in close proximity to the limbic system. CONCLUSIONS: Lesionectomy, with removal of surrounding hemosiderin-stained brain, can be considered the procedure of choice in carefully selected patients with epilepsy with occult vascular malformations.

Duke Scholars

Published In

Epilepsia

DOI

ISSN

0013-9580

Publication Date

June 1998

Volume

39

Issue

6

Start / End Page

600 / 607

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, Emission-Computed
  • Neurology & Neurosurgery
  • Neocortex
  • Male
  • Limbic System
  • Intracranial Arteriovenous Malformations
  • Humans
  • Hemosiderin
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Kraemer, D. L., Griebel, M. L., Lee, N., Friedman, A. H., & Radtke, R. A. (1998). Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy. Epilepsia, 39(6), 600–607. https://doi.org/10.1111/j.1528-1157.1998.tb01428.x
Kraemer, D. L., M. L. Griebel, N. Lee, A. H. Friedman, and R. A. Radtke. “Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy.Epilepsia 39, no. 6 (June 1998): 600–607. https://doi.org/10.1111/j.1528-1157.1998.tb01428.x.
Kraemer DL, Griebel ML, Lee N, Friedman AH, Radtke RA. Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy. Epilepsia. 1998 Jun;39(6):600–7.
Kraemer, D. L., et al. “Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy.Epilepsia, vol. 39, no. 6, June 1998, pp. 600–07. Pubmed, doi:10.1111/j.1528-1157.1998.tb01428.x.
Kraemer DL, Griebel ML, Lee N, Friedman AH, Radtke RA. Surgical outcome in patients with epilepsy with occult vascular malformations treated with lesionectomy. Epilepsia. 1998 Jun;39(6):600–607.
Journal cover image

Published In

Epilepsia

DOI

ISSN

0013-9580

Publication Date

June 1998

Volume

39

Issue

6

Start / End Page

600 / 607

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Tomography, Emission-Computed
  • Neurology & Neurosurgery
  • Neocortex
  • Male
  • Limbic System
  • Intracranial Arteriovenous Malformations
  • Humans
  • Hemosiderin
  • Follow-Up Studies