Article
Radiotherapy-induced cavernomas in children – development and clinical course
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Published: | May 20, 2009 |
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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.