Clinical range and outcomes of cerebral cavernous malformations in pediatric patients: A single center data results

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Abstract
Purpose Cerebral cavernous malformations (CCMs) are vascular abnormalities that have been reported in the literature to cause seizures, headaches, intracerebral hemorrhages, gait ataxia, and focal neurological deficits. This study aims to review pediatric cases of CCMs in a single reference center. Materials and methods The retrospective data files of 6 Turkish CCM patients were evaluated. All the patients underwent magnetic resonance imaging (MRI) studies that included diffusion-weighted imaging, and susceptibility-weighted imaging (SWI). During a detailed neurological examination, the clinical and family history, age at the onset of symptoms, detailed neuroimaging findings, electroencephalogram (EEG) records, and outcomes of the patients were documented. Results The female to male ratio was 3/3. The age at the onset of symptoms was between 2.25 and 11 years (mean: 17.37 ± 3.26 years). The neurological manifestations on admission were: intracranial hypertension and cerebral hemorrhages (n: 1), seizures (n: 2), speech delays and articulation phonation problems (n: 2), and specific learning disability disorders (n: 1). The common neuroimaging findings of all the patients were that all of them had CCMs on their SWI sequences and were type 4 on the Zambramski classification of cerebral cavernomas. Conclusions Specific learning disabilities, speech delays and phonation problems, and focal and multifocal epileptic EEG discharges, with or without clinical seizures, can be indicators of underlying pediatric CCMs. The sensitivity of SWI in detecting CCMs was very high in children, as all the patients’ lesions in this study were type 4 on the Zambramski classification of cerebral cavernomas.

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