He K, et al. – An analysis was performed to assess the effectiveness of surgery as a treatment for supratentorial cerebral cavernous malformation (CCM)–associated epilepsy (SCCMAE) and ascertain the factors that affect outcomes. To treat SCCMAE, this study supported the efficacy of using surgery. After surgery, a shorter duration of preoperative epilepsy was correlated with better seizure control. At the 1–year follow–up, patient status was a reliable indicator of long–term Engel Class I epilepsy control.

• The authors enrolled 181 consecutive patients who were diagnosed with SCCMAE and surgically treated in a single institute during the 5year period from2005 to 2009.
• For at least 5 years post-operatively, each patient was followed up.
• They performed a time-to-event analysis using Kaplan-Meier curves and Cox regression models to assess the associated risk factors.

• At seizure onset, the age was 30.6±14.3 years old, and the age at the time of surgery was 33.4±14.6 years old.
• The female: male ratio was 0.81:1 and the mean diameter of the cerebral cavernous malformation (CCM) was 2.0 cm.
• The CCM was removed with (in 14 cases) or without (in 28 lesions) the peripheral hemosiderin for CCMs involving eloquent brain areas.
• In this study, none of the patients suffered from long-term neurological disabilities.
• The authors achieved an Engel Class I outcome in 89.0%, 83.4%,81.8%, and 80.1% of the patients after 6months, 1year, 2.5years and5-years of follow-up, respectively.
• The prevalence of seizure remission at 5 years post operative was 96.0% (95% CI 94.4-97.6%) in patients who were Class I after 1 year.