Objective: To study the methods and effectiveness of image-guided microsurgery in resection of intracranial cavernous hemangioma.
Methods: Between July 1997 and January 2001, 44 patients with intracranial cavernous hemangioma, 27 males and 17 females with a mean age of 35 years, among which 5 cases had multiple lesions, underwent image-guided microsurgery. The locations of lesions included frontal lobe (n = 14), temporal lobe (n = 12), parietal lobe (n = 6), cerebellum (n = 6), thalamus (n = 5), pons (n = 5), and orbital lobe (n = 1). A small silicon catheter, used as a guider, was implanted to the deep-seated lesion (except the brain stem lesions) before excision of the lesion in order to prevent brain shift.
Results: Total removal of the lesions was achieved in all patients without operational death. Follow-up revealed marked improvement of symptoms in 26 case and no change of symptom(s) in 13 cases. 5 cases suffered from additional neurological deficits, mainly exacerbation of hemiparalysis and aphasia, the condition of two of which, however, gradually improved within the period of follow-up. No residue of lesion and relapse were found during follow up.
Conclusion: With the assistance of the image-guided surgical system, functional area can be effectively avoided, and surgical injury can be decreased. It is well suited for accurate localization and safe resection of small, deep-seated cavernous malformations.