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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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Radiotherapy-induced cavernomas in children – development and clinical course

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  • O. Müller - Neurochirurgische Klinik, Universitätsklinikum Essen
  • B. Schoch - Neurochirurgische Klinik, Universitätsklinikum Essen
  • F. Rademacher - Neurochirurgische Klinik, Universitätsklinikum Essen
  • M. Schlamann - Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen
  • E. Sandalcioglu - Neurochirurgische Klinik, Universitätsklinikum Essen
  • R. Wieland - Abteilung für Hämatologie, Onkologie und Endokrinologie, Universitäts-Kinderklinik Essen
  • U. Sure - Neurochirurgische Klinik, Universitätsklinikum Essen

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.08-03

doi: 10.3205/09dgnc046, urn:nbn:de:0183-09dgnc0466

Published: May 20, 2009

© 2009 Müller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Our objective was to evaluate the clinical course of cavernomas after radiotherapy in paediatric patients with brain tumours and to define the necessity of a close follow-up.

Methods: This observational study includes 55 children, treated with radiotherapy due to an underlying brain tumour disease irrespective of the location intracranially. Initial MRIs were compared with those at latest follow-up with special attention to the development of cavernomas and their clinical course.

Results: Cavernomas were detected in 12 out of 55 children. Mean time of overall clinical follow-up in the 55 children was 60,7 months. In the group of patients harbouring a cavernoma, mean time until the detection of the cavernomas was 64 months. 4 of 12 cavernomas developed within the first 4 years (odds ratio 0,1). Occurence rate increased until the 6th year, up to when 75% of all cavernomas had developed (odds ratio 0,2). 3 of 12 patients' MRI showed a clinically silent haemorrhage of the cavernoma. 2 of those bled within 6 months after initial detection. In 4 children cavernomas developed at multiple sites.

Conclusions: Early appearance of cavernomas after radiotherapy has not come to attention in clinical practice. As we showed in our study, cavernomas may develop at multiple sites and tend to bleed, even though we did not observe a clinical deterioration in our patients. Therefore a follow-up with MRI has to be distended for the early detection of cavernomas with haemo-weighted sequences. Parents have to be enlightened about the potential risks of this co-morbidity.