Smolanka A. Clinical-diagnostic features and treatment strategy of brain cavernomas

The thesis is devoted to optimisation of the treatment strategy in patients with brain cavernomas by analysing the clinical course of the disease, diagnostical features and individualisation of surgical strategy. Typical difference in clinical course of supra- and infratentorial cavernomas was found. Surgical indications in patients with epileptogenic supratentorial cavernomas were developed and resection of cavernoma with perifocal hemosiderosis was proposed, which provided high effectiveness of surgical treatment in this group of patients. Treatment strategy in patients with supratentorial cavernomas which present with hemorrhage and multiple brain cavernomas was also optimised. Treatment algorithm for patients with brainstem cavernomas depending on their location and number of hemorrhages was developed. Optimal timing of surgery after hemorrhage was proposed (subacute hemorrhage) and model for choice of surgical approach was adapted.