Excision of cavernous angioma with preservation of coexisting venous angioma

Sasaki, Osamu; Tanaka, Ryuichi; Koike, Tetsuo; Koide, Akira; Koizumi, Takayuki; Ogawa, Hiroshi

doi:10.3171/jns.1991.75.3.0461

Cited by 62 publications

(29 citation statements)

References 8 publications

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“…An anecdotal report 19 of gross connections between a CM and its associated venous anomaly is at odds with our observations during routine excision of CMs, in which we leave their associated venous malformation intact. Moreover, in a study in which investigators compared the histological and ultrastructural anatomy of unruptured and hemorrhagic CMs, they failed to document direct evidence of a communication or continuity between normal-appearing veins and a CM.…”

Section: Neurosurg Focus / Volume 21/ July 2006contrasting

confidence: 72%

Intraoperative rupture of brainstem cavernous malformation

Leković¹,

Gonzalez²,

Khurana³

et al. 2006

FOC

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✓Although cavernous malformations (CMs) are an important cause of intracranial hemorrhage, the natural history of these lesions is controversial. Both retrospective and prospective studies undertaken to define risk factors for hemorrhage from CMs have consistently identified the location of a lesion as a factor that has a significant impact on the rate of rupture, and brainstem CMs consistently have a higher rate of symptomatic hemorrhage than those at other locations. The mechanism underlying this disparity in rupture rates, however, remains obscure. Most authors attribute the difference, at least partially, to the sensitivity of the brainstem to hemorrhage. Regardless, the specific factors that cause a given CM to rupture are unknown. The authors report their first encounter with an intraoperative rupture of a CM in the brainstem. This case underscores the risks encountered during the surgical approach to brainstem CMs and may provide insight into the pathophysiological mechanisms underlying the rupture of these lesions.

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Section: Neurosurg Focus / Volume 21/ July 2006contrasting

confidence: 72%

Intraoperative rupture of brainstem cavernous malformation

Leković¹,

Gonzalez²,

Khurana³

et al. 2006

FOC

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“…Sacrifice of the DVA will invariably lead to a venous infarct with disastrous clinical sequelae. 32,46,50,53 Developmental venous anomalies are usually absent in patients with familial CMs. 44 …”

Section: General Clinical and Surgical Considerationsmentioning

confidence: 99%

Brainstem cavernous malformations: anatomical, clinical, and surgical considerations

Giliberto

Lanzino²,

Diehn

et al. 2010

FOC

112

103

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Symptomatic brainstem cavernous malformations carry a high risk of permanent neurological deficit related to recurrent hemorrhage, which justifies aggressive management. Detailed knowledge of the microscopic and surface anatomy is important for understanding the clinical presentation, predicting possible surgical complications, and formulating an adequate surgical plan. In this article the authors review and illustrate the surgical and microscopic anatomy of the brainstem, provide anatomoclinical correlations, and illustrate a few clinical cases of cavernous malformations in the most common brainstem areas.

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“…Reports of the AOVMs associated with DVAs are increasing. 1,3,8,10,12,19,30,37,45,46,53,60,61,66) Neurological symptoms or complications have been attributed to AOVMs rather than DVAs. The exact nature of the association is unknown, but certain DVAs are assumed to cause regional venous hypertension, which may facilitate formation of AOVMs.…”

Section: Dvasmentioning

confidence: 99%

Histologically Classified Venous Angiomas of the Brain: A Controversy.

Abe

Hagihara

Tabuchi

et al. 2003

Neurol. Med. Chir.(Tokyo)

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The term``venous angioma'' (VA) usually refers to a developmental venous anomaly (DVA). However, a group of vascular malformations called VAs shows no venous abnormalities on angiography. The clinical and histological features of histologically classified VAs were studied in eight patients who presented with hemorrhage or seizures to reevaluate these venous anomalies. Angiography showed no venous abnormalities in six patients. Histological study included immunostaining for smooth muscle actin and glial fibrillary acidic protein. Surgical specimens of 10 cases of cavernous angiomas, 10 cases of arteriovenous malformations, and two cases of capillary telangiectasias were studied to compare these types of VAs. Angiographically occult VAs were surgically removed safely, whereas removal of DVAs was complicated by brain swelling and hemorrhagic infarction of the brain. Histological examination found angiographically occult VAs contained malformed and compactly arranged vessels with partly degenerated walls, whereas DVAs had dilated thin-walled vessels that were diffusely distributed in the normal white matter. This study of our cases and a review of the reported cases of VAs suggests that two different clinical and pathological entities are commonly categorized as``VA,'' angiographically occult VAs and DVAs. These two entities should be carefully distinguished.

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Excision of cavernous angioma with preservation of coexisting venous angioma

Cited by 62 publications

References 8 publications

Intraoperative rupture of brainstem cavernous malformation

Intraoperative rupture of brainstem cavernous malformation

Brainstem cavernous malformations: anatomical, clinical, and surgical considerations

Histologically Classified Venous Angiomas of the Brain: A Controversy.

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