Cavernomas: análisis de 13 casos pediátricos
DOI:
https://doi.org/10.59156/revista.v0i0.682Palabras clave:
Cavernoma, Hemorragia intracraneal, Malformación cavernosa, Neurocirugía pediátricaResumen
Introducción: las malformaciones cavernosas (MC) o cavernomas (C) son malformaciones vasculares de bajo flujo, angiográficamente ocultas y con características por imágenes de resonancia magnética que pueden definir el tiempo de degradación de la hemoglobina e incluso pequeños niveles líquidos. Corresponden a una de las principales causas de sangrado cerebral en pediatría, y pueden ser esporádicas, o de tipo familiar y con lesiones múltiples. La remoción microquirúrgica se recomienda en casos sintomáticos y accesibles anatómicamente.
Objetivos: reportar nuestra serie de casos de cavernomas y comparar la información con la literatura publicada.
Material y métodos: estudio descriptivo retrospectivo de serie de casos de pacientes con diagnóstico de cavernomas entre abril de 2016 y abril de 2022, con revisión de historias clínicas, neuroimágenes, partes quirúrgicos y anatomopatológicos. Se recopilaron datos filiatorios, presentación clínica, localización, tipo de tratamiento, evolución y hallazgos por imágenes.
Resultados: se incluyeron 13 pacientes, 8 varones y 5 mujeres. Rango etario de 7 meses a 16 años (media 8.7 años); 3 pacientes (23%) con diagnóstico de cavernomatosis múltiple familiar; 6 supratentoriales corticales, 2 supratentoriales profundas, 3 en tronco encefálico, 1 cerebeloso y 1 medular. Doce casos (92%) debutaron con sangrado sintomático. Once (85%) requirieron cirugía, todos sintomáticos: 9 (82%) por primer sangrado y 2 (18%) en resangrado. El 100% resección total. Mejoría clínica postquirúrgica en el 91%. La media de seguimiento fue de 2.5 años. Se destacan 7 casos para su mayor análisis.
Conclusión: los cavernomas son entidades dinámicas que requieren seguimiento y debe considerarse la oportunidad quirúrgica, sobre todo en pacientes pediátricos con larga expectativa de vida. En lesiones sintomáticas y anatómicamente accesibles se logran resultados satisfactorios con resección quirúrgica completa.
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