Quality of life following brainstem cavernoma surgery in 71 patients

BACKGROUND: Symptomatic patients harboring a brainstem cavernoma are treated surgically with increasing frequency. Generally, the patient's benefit from this difficult surgical intervention is quantified by the assessment of neurological symptoms. OBJECTIVE: To document the beneficial effect of surgery in a larger patient population by assessing the postoperative quality of life (QoL). METHODS: In a series of 71 surgically treated patients, a detailed neurological status was assessed by Patzold Rating and Karnofsky Performance Status Scale (KPS). Patients rated their QoL with the SF-36 questionnaire. To document the effect of surgery on QoL, we devised a supplementary questionnaire. The last 24 patients completed SF-36 pre- and postoperatively. RESULTS: KPS improved in 44 of 71 surgical patients (62%), remained unchanged in 19 (27%) and deteriorated in 8 (11%) individuals. Patzold Rating showed a more detailed picture of the neurological symptoms. It correlated significantly with KPS, which underlines its usefulness for patients with brainstem lesions. In the SF-36 score the Mental Component Summary (MCS) improved with surgery (paired test, p = 0.015). In addition, 58 individuals (82%) declared a clear subjective benefit of surgery. CONCLUSION: The results of this large series support the notion that microsurgical removal of a brainstem cavernoma represents an effective therapy in experienced hands, and is generally associated with good clinical outcome, both neurologically and in terms of QoL.