• World Neurosurg · Dec 2018

    Meta Analysis

    Is Extended Lesionectomy Needed for Patients with Cerebral Cavernous Malformations Presenting with Epilepsy? A Meta-Analysis.

    • Huang-Cheng Shang-Guan, Zi-Yu Wu, Pei-Sen Yao, Guo-Rong Chen, Shu-Fa Zheng, and De-Zhi Kang.
    • Department of Critical Medicine, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China; Department of Neurosurgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
    • World Neurosurg. 2018 Dec 1; 120: e984-e990.

    ObjectiveTo determine whether extended lesionectomy is needed for patients with cerebral cavernous malformations presenting with epilepsy as compared with lesionectomy.MethodsA literature search of PubMed, Embase, Web of Science, Clinical Trials and Cochrane Central Register of Controlled Trials was performed for pertinent English-language studies from 1967 to 2017. Eligible studies were selected according to uniform inclusion and exclusion criteria.ResultsSeven studies including 245 patients (107 receiving extended lesionectomy, 138 receiving lesionectomy) were selected. Meta-analysis and subgroup analyses were conducted to compare extended lesionectomy with lesionectomy. Pooled analysis demonstrated that seizure outcome was not statistically significantly improved in patients who underwent extended lesionectomy compared with lesionectomy (odds ratio = 0.77; 95% confidence interval, 0.39-1.51; P = 0.44; I2 = 15%).ConclusionsExtended lesionectomy does not contribute to better seizure control for patients with cerebral cavernous malformations with epilepsy. Resection of the lesion and surrounding hemosiderin is sufficient for patients with cerebral cavernous malformations presenting with epilepsy.Copyright © 2018 Elsevier Inc. All rights reserved.

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