Spontaneous Occlusion of an Intracranial Arteriovenous Malformation

Symptomatic intracranial hemorrhage (ICH) in term infants is not common, but when it occurs it is usually secondary to trauma, coagulation disorders and/or hypoxia. The possibility of a structural cause for an infantile ICH is unfortunately not seriously considered until very late. In this paper we report the cases of five full-term infants, each of whom developed ICH secondary to a structural lesion during the 1st year of life. Three presented during the newborn period. A congenital saccular aneurysm of the middle cerebral artery in an 8-month old male infant; a posterior fossa arteriovenous malformation in a 2-week old female neonate; a deep parietal cavernous angioma in a 6.5-month-old male infant; a temporoparietal low-grade astrocytoma in a 12-day old male neonate and a temporoparietal desmoplastic ganglioglioma in a 9-day-old male neonate were the structural lesions that were causative for hemorrhage. In all cases but one, the diagnosis was reached by computerized tomography and/or magnetic resonance imaging. All infants underwent surgery for the removal of the hematoma and of the lesion causative for the bleed. All are alive at 19, 3, 11.5, 10, and 5 years, respectively. We discuss the diagnosis of ICH with special emphasis on contemporary imaging modalities and stress the benefits of aggressive and timely surgical treatment. We then consider a concise analysis of the world literature on the occurrence of structural causes of ICH during infancy.

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“…Seventy-five percent of all hemorrhage cases were in neonates. Hydrocephalus occurred in 16 (25%) of the infant cases [1, 26,47,49,50,59,64,82].…”

Section: Arteriovenous Malformations In Infantsmentioning

confidence: 99%

“…Spontaneous thrombosis was described in 5 infants, with poor outcome in 2 [1, 27,49,59,64]. Treatment for the AVM was considered in 50 infants.…”

Section: Arteriovenous Malformations In Infantsmentioning

confidence: 99%

Spontaneous intracranial hemorrhage of structural origin during the first year of life

Tekkök

Ventureyra

1997

Child's Nervous System

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“…Los estudios moleculares realizados sobre muestras de MAV mostraron un medio altamente angiogénico con aumento del recambio de células endoteliales e inflamatorias, y un incremento de la remodelación vascular. Además, la existencia de casos de MAV de novo, la evidencia de que MAV extirpadas vuelven a aparecer, o los numerosos casos que angiográficamente han crecido, hacen pensar que no son estáticas, sino que están sometidas a factores genéticos y/o ambientales que las hacen cambiar a lo largo de la vida 10 .…”

Section: Discussionunclassified

Malformación arteriovenosa intracraneal múltiple

et al. 2015

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“…The association of AC and arteriovenous malformations has been described 10 . Thus, an MR angiography was requested and demonstrated no vascular abnormalities.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous acute subdural hematoma contralateral to an arachnoid cyst

Henriques

Filho

Henriques

et al. 2007

Arq. Neuro-Psiquiatr.

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-Arachnoid cysts (AC) are extra-cerebral cerebrospinal fluid collections of unknown origin. They correspond to 1% of all intracranial nontraumatic space-occupying lesions and appear more frequently in the middle fossa (50%). More than 25% of these cysts are incidental findings and the majority of patients are asymptomatic. Seizures, intracranial hypertension signs, neurological deficits, macrocrania, developmental delay and bulging of the skull are the main signs and symptoms of the lesion. AC rupture and bleeding are rare, usually occurring in young adults and associated with trauma. The risk of hemorrhage does not exceed 0.04% / year. We describe the case of a ten-year-old boy who presented with acute signs of intracranial hypertension secondary to a spontaneous acute subdural hematoma, contralateral to an AC of the middle fossa. Three factors were significant in this case: signs and symptoms occurred spontaneously; the presence of an acute subdural hematoma exclusively contralateral to the AC; successful outcome of the conservative treatment.KEY WORDS: arachnoid cyst, subdural hematoma, pediatric neurosurgery. Hematoma subdural agudo espontâneo contralateral a cisto aracnóideoRESUMO -Os cistos aracnóideos (CA) são coleções liquóricas extra-cerebrais e intra-aracnóideas de origem desconhecida. Correspondem a 1% de todas as lesões expansivas intracranianas não traumáticas e têm ní-tido predomínio na fossa média (50%). Até 25% destes cistos são achados incidentais sendo que a maioria dos pacientes é assintomática. Crises epilépticas, sinais de hipertensão intracraniana, déficits neurológicos focais, macrocrania, atraso no desenvolvimento e abaulamento da calota craniana são os principais sinais e sintomas da lesão. A ruptura dos CA, assim como seu sangramento, são situações raras, geralmente associadas a traumas e acometem adultos jovens. O risco de hemorragia em pacientes com CA não excede 0,04% ao ano. É descrito caso de paciente de dez anos de idade que subitamente apresentou sinais de hipertensão intracraniana secundários a hematoma subdural agudo espontâneo, contralateral a volumoso CA de fossa média. Três fatores foram de relevância neste paciente: a ocorrência de sinais e sintomas espontaneamente, especialmente em um menino; presença de hematoma subdural agudo exclusivamente contralateral ao CA; e a boa evolução com o tratamento conservador. PALAVRAS-CHAVE: cisto aracnóideo, hematoma subdural, neurocirurgia pediátrica.

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Spontaneous Occlusion of an Intracranial Arteriovenous Malformation

Cited by 13 publications

References 8 publications

Spontaneous intracranial hemorrhage of structural origin during the first year of life

Spontaneous intracranial hemorrhage of structural origin during the first year of life

Malformación arteriovenosa intracraneal múltiple

Spontaneous acute subdural hematoma contralateral to an arachnoid cyst

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