Characteristics of cavernomas of the brain and spine

Kivelev, Juri; Niemelä, Mika; Hernesniemi, Juha

doi:10.1016/j.jocn.2011.08.024

Cited by 34 publications

(44 citation statements)

References 72 publications

(113 reference statements)

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“…2 The higher frequency of CCMs in our cohort may be explained by use of a 3-T MRI with T2* sequence, which increases the sensitivity for detecting CCMs. 8 We additionally identified 11 patients with CCMs in MRI after initial CT-based thrombolysis.…”

Section: Discussionmentioning

confidence: 80%

“…The CCM was seen on a CT scan before thrombolysis, and therefore was probably a type I or II CCM (because type III and IV CCMs are not visible on CT imaging). 2 Considering that DWI on MRI after thrombolysis was negative in this patient, they also discussed the possibility of having treated a stroke mimic. 6 Therefore, one may speculate that the risk of ICH is higher in patients with symptomatic type I or II CCM and that ICH preferentially occurs at the site of CCM.…”

Section: Discussionmentioning

confidence: 96%

“…1 However, some of the contraindications for the use of r-tPA were developed without sufficient safety data, and additional data are needed to inform on the risk of hemorrhage after thrombolysis. Cerebral cavernous malformations (CCMs), which consist of clusters of sinusoids covered by a single layer of endothelium, 2 are not explicitly named as a contraindication. The reliable diagnosis of CCMs requires use of MRI.…”

mentioning

confidence: 99%

“…The reliable diagnosis of CCMs requires use of MRI. 2 The incremental use of MRI in acute stroke care uncovers an increasing number of CCMs in patients with acute ischemic stroke and confronts the physician with the question of their clinical relevance. We addressed this question by assessing (1) frequency of coexistent CCM in patients with acute ischemic stroke receiving intravenous r-tPA, and (2) frequency of symptomatic intracerebral hemorrhage (sICH) or parenchymal intracerebral hemorrhage (PH) in these patients.…”

mentioning

confidence: 99%

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Safety of Thrombolysis in Patients With Acute Ischemic Stroke and Cerebral Cavernous Malformations

Erdur

Scheitz

Tütüncü

et al. 2014

Stroke

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Background and Purpose-Data on safety of intravenous thrombolysis with recombinant tissue-type plasminogen activator for acute ischemic stroke in patients with coexisting cerebral cavernous malformations (CCMs) are scarce. We assessed the risk of thrombolysis-associated hemorrhage in these patients. Methods-We searched our tertiary care hospital thrombolysis register for patients with CCM confirmed by MRI (3 T, Siemens, TimTrio) before thrombolysis for acute ischemic stroke. CCMs were graded into subtypes according to the Zabramski classification on the basis of their MRI appearance. The primary end point was symptomatic intracerebral hemorrhage according to European Cooperative Acute Stroke Study III (ECASS III) criteria. The secondary end point was any parenchymal hemorrhage.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Safety of Thrombolysis in Patients With Acute Ischemic Stroke and Cerebral Cavernous Malformations

Erdur

Scheitz

Tütüncü

et al. 2014

Stroke

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“…29,36) The major symptoms are bleeding-related neurological symptoms and seizures. 21) The annual incidence of bleeding at all lesion sites is 0.6% to 0.7%, and the re-bleeding rate following the first bleeding episode is relatively high (4.5%/year), particularly in young women. 22,29) Cases of familial CM are also encountered, with a higher reported incidence of bleeding (1.1%/year) in this subset of patients.…”

Section: Introductionmentioning

confidence: 98%

Cavernous Malformations in Pregnancy

Yamada

Nakase

Nakagawa

et al. 2013

Neurol. Med. Chir.(Tokyo)

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Cavernous malformation is a relatively rare disease, but is important in the etiology of cerebral hemorrhage in pregnant and puerperal women. The risk of bleeding is particularly high in patients with a previous history of bleeding, patients with a family history of cavernous malformations, and patients with the causative cerebral cavernous malformation gene. Cavernous malformations are more likely to bleed or to increase in size during pregnancy, under the influence of female hormones and vascular growth factors such as vascular endothelial growth factor. We report our strategy for the treatment of cavernous malformations in pregnant women, with reference to the relevant literature. Asymptomatic patients and those with mild symptoms are usually followed up conservatively by magnetic resonance imaging, without active treatment, but surgical treatment is indicated in patients with severe or progressive symptoms; surgery should also be considered in patients with mild symptoms having risk factors for bleeding. If surgical treatment is selected, the operation plan needs to be devised in collaboration with the specialties of anesthesiology and obstetrics and gynecology, rather than by the brain surgeon alone, in view of the possibility of occurrence of complications specific to pregnant women, such as complications related to weight gain and difficulty in securing the airway, which develop during the perioperative period.

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