Extraaxial cavernous hemangioma with hemorrhage (original) (raw)
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Cavernous angioma of the VIIIth cranial nerve
Neurosurgical Review, 1998
We report a case of a 24-year-old woman affected by a cavernous angioma of the right VIIIth cranial nerve associated with a venous angioma. The malformation was diagnosed by MRI, performed in relation to an acute onset of right anacusia. The case report is indicative that, even if unusual, an acute onset of an cerebellopontine angle syndrome can be subsequent to a bleeding cavernous angioma. This occurrence must be kept in mind in the differential diagnosis of the cerebellopontine angle tumors.
Cavernomas of the central nervous system: clinical and neuroimaging manifestations in 47 patients
Journal of Neurology, Neurosurgery & Psychiatry, 1991
Forty seven cases of central nervous system cavernous angioma (21 males and 26 females) are described. The main clinical signs were epilepsy and brainstem syndromes. Digital subtraction intraarterial angiography, when used, failed to reveal cavernoma. CT detected many of the lesions, but the most successful supplementary diagnostic procedure was MRI which produces highly characteristic images of cavernous angioma. The diagnosis of cavernous angioma was confirmed in the 18 cases in which the tumour was removed surgically. group.bmj.com on July 25, 2011 -Published by jnnp.bmj.com Downloaded from I Requena, M Arias, L López-Ibor, et al. 47 patients. clinical and neuroimaging manifestations in Cavernomas of the central nervous system: http://jnnp.bmj.com/content/54/7/590
Cavernoma in the medulla oblongata – Case presentation and review of the literature
Romanian Journal of Neurology
Cerebral cavernous venous malformations (also called cavernous hemangiomas or cavernomas) are the third most common cerebral vascular malformations having an incidence of 0.4-0.8% in the general population and being diagnosed more frequently incidentally during an imaging procedure. Usually solitary, but cavernomas can also be present as multiple lesions with autosomal dominant inheritance pattern. We present a rare case and the MRI imaging of a type I Zabramski cavernoma that bled, localized in the medulla oblongata of a 41-year-old man, admitted with paresthesia of the right upper limb, very mild right hemiparesis and impaired fine motor movements of the right hand and intractable persistent hiccups.
Cavernous angiomatosis of the central nervous system: usefulness of screening the family
Acta Neurologica Scandinavica, 2009
A 23-year-old woman presented with cerebellar hemorrhage from a cavernous angioma (CA). A history of spinal hemorrhage and a supratentorial calcified lesion on CT and MRI suggested cavernous angiomatosis of the CNS. Familial investigation in 20 relatives revealed 4 additional patients with symptomatic CA and one person with asymptomatic CA. In the symptomatic patients, CA had not been recognized as the cause of their neurologic symptoms prior to our investigation. The number of CA lesions in asymptomatic relatives was low. This study shows that, when a patient with cavernous angiomatosis of the CNS is encountered, systematic clinical and MRI investigations in other family members with a history or symptoms of neurologic disorder should be carried out.
Intracranial cavernous angioma: presentation and management
Journal of Neurosurgery, 1986
✓ Thirteen cases of cerebral cavernous angiomas are reported, and their radiological and pathological features are reviewed. The clinical presentation was variable: 53.8% of patients had seizures, 30.8% intracerebral hemorrhage, and 15.4% focal neurological signs, including one unusual case that presented as a cerebellopontine angle tumor. The computerized tomography (CT) scans were abnormal in all cases. Angiography was positive only when there was mass effect due to associated hematoma. Surgery was performed in 12 cases with good results. The prognosis of the 13 cases was favorable, with no mortality in this series. These data suggest that the combination of a recent seizure disorder with a hyperdense intracerebral nodule on the CT scanning should alert the neurosurgeon to the possibility of a cavernous angioma.
Cavernous malformations isolated from cranial nerves: Unexpected diagnosis?
Clinical Neurology and Neurosurgery, 2014
Objectives: Cranial nerves (CN) cavernous malformations (CMs) are lesions that are isolated from the CNs. The authors present three cases of CN CMs, for which MR was demonstrated to be critical for management, and surgical resection produced good outcomes for the patients. Surgical removal is the recommended course of action to restore or preserve neurological function and to eliminate the risk of future haemorrhage. However, the anatomical location and the complexity of nearby neural structures can make these lesions difficult to access and remove. In this study, the authors review the literature of reported cases of CN CMs to analyse the clinical and radiographic presentations, surgical approaches and neurological outcomes. Patients and methods: A MEDLINE/Pub Med search was performed and revealed 86 cases of CN CMs. The authors report three additional cases in this study for a total of 89 cases. CMs affecting the optic nerve (CN II), oculomotor nerve (CN III), facial/vestibule-cochlear nerves (CN VII, CN VIII) have been described. The records of three patients were reviewed with respect to the lesion locations, symptoms, surgical approaches and therapeutic considerations. Clinical and radiological follow-up results are reported. Three patients (2 females, 1 male; age range 21-37 year) presented with three CN lesions. One lesion involved CN III, one lesion involved CN VII-CN VIII, and one involved CN II. The patient with the CN III lesion had a one-month history of mild right ptosis and diplopia. The patient with the CN VII-CN VIII lesion exhibited acute hearing loss and on the left and left facial paresis. The patient with the opticchiasmatic lesion presented with acute visual deterioration on the right and a left temporal field deficit in the left eye. Pterional and orbitozygomatic craniotomies were performed for the CN III lesion and the CN II lesion, and retrosigmoid craniotomy was performed for the cerebello-pontine angle lesion. Results: All patients experienced symptom improvement after surgery. On MR follow-up, recurrence was excluded in all patients. Conclusions: CN CMs present with specific symptoms and require complex surgical techniques for resection. These lesions are frequently symptomatic, because of the complexity of the origin tissue. Symptomatic CN CMs should be resected microsurgically and completely when possible to prevent further losses of nerve function, improve function, avoid recurrence, and to eliminate the risk of future haemorrhages. The authors discuss the therapeutic options and the radiological features of these infrequent localisation of CMs. Specifically, the authors focus on the role of magnetic resonance imaging in the identification of these rare lesions.
Acta Neurochirurgica, 1987
We present our clinical experience and the results of surgical management with 25 cavernomas of the CNS, treated in our hospital in the last 10 years. The location of the lesion assessed by clinical and CT scan examinations, proved to be the most significative factor determining the prognosis of cavernomas of the CNS, after surgical removal. The symptoms started in most of the cases in the third decade of life. 19 cases were located in the cerebral hemispheres and produced three well defined clinical syndromes: Irritative syndrome (seizures) present in 70% of the cases. Space-occupying lesion syndrome (20%) and haemorrhagic syndrome (10%). The remaining six cases were located within the basal ganglia, brainstem, pineal region, cerebellum and spinal cord, showing a progressive course. CT scan studies were performed on 24 cases. The characteristic image of a cavernoma is represented by a moderately hyperdense nodule with discreet contrast uptake. Calcification was observed in and around the lesions in 33% of the cases. Perilesional hypodensities suggestive of brain tissue atrophy were noted in 22% of the CT scans. On the other hand, 12% of cerebral hemisphere cavernomas showed atypical CT scan images that suggested an erroneous diagnosis of cystic gliomas. Radical surgical removal was performed in all cases. The postoperative results varied according to the location of the lesions. Complete recovery was obtained with cerebral hemisphere cavernomas presenting with a progressive history suggesting tumour or a haemorrhagic syndrome. 85% of the cases presenting with seizures, were symptom-free and taking no anticonvulsants 1 year after surgery. In deeply placed cavernomas (basal ganglia and brainstem) the surgical results were poor. In the latter cases surgery has to be carefully evaluated when a mode of treatment is to be considered in patients whose CT scan data strongly suggest a diagnosis of cavernoma.