Sturge-Weber disease with unusual cerebral atrophy and hydrocephalus

Campistol, Jaume; García-Cazorla, A; Gonzalez-Campo, C.

doi:10.1016/s1090-3798(99)90086-7

Cited by 2 publications

(1 citation statement)

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“…These changes can be documented by CT and MRI, 1,15,18 and often appear in the neonate. [19][20][21] These abnormalities have a vascular origin 19,22 and may be due to changes in the vessel permeability and stasis in the vascular lumen which cause anoxic lesions in the endothelium. Some patients may have acute episodes of intracranial hypertension probably caused by impairment of cerebral venous outflow.…”

Section: Discussionmentioning

confidence: 99%

Sturge-Weber Syndrome. Study of 55 Patients

Pascual-Castroviejo

Pascual-Pascual

Velazquez-Fragua

et al. 2008

Can. j. neurol. sci.

189

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Purpose: To review the clinical and neuroimaging features of a large series of patients with Sturge-Weber syndrome (SWS) seen over a 40-year period. Methods: Fifty-five patients with SWS (30 males and 25 females), were studied between 1965 and 2004. Results of neurological and ophthalmological examinations, electroencephalographic, and neuroimaging studies were reviewed. All patients were seen by one of the authors (I. P-C). Results: Epilepsy, hemiparesis, mental retardation and ocular problems were the most frequent and severe features of patients with Sturge-Weber syndrome in this series. The facial nevus flammeus was unilateral in 35 (63.5%) patients, bilateral in 17 (31%) and absent in 3 (5.5%) of the patients with leptomeningeal angiomas. Seven (41%) of the 17 patients with bilateral nevus flammeus had unilateral leptomeningeal angiomas. Seizures occurred in 47 patients (85.5%). Complete seizure control was obtained in 20 patients (42.5%), but in 2 of these 20 patients seizures were controlled only after lobectomy. All patients with unilateral or bilateral upper eyelid nevus flammeus had ipsilateral, unilateral or bilateral choroid-retinal angiomas. Only 20 (36%) of the 55 patients had low-normal or borderline intelligence (IQs<70). No relationship was observed between the size of the facial nevus flammeus and the severity of the brain lesion. Conclusions: Epilepsy, hemiparesis, mental retardation and ocular problems were the most frequent and severe features of patients with Sturge-Weber syndrome in this series. Cerebral lesions followed a progressive course during early childhood, but not later. Early surgical treatment controlled the seizures but other neurological problems such as hemiparesis and intellectual deficits showed a less satisfactory response. Early onset of seizures and poor response to medical treatment, bilateral cerebral involvement and unilateral severe lesions were indicative of a poor prognosis. Limited intelligence and social skills, poor aesthetic appearance and seizures complicated the integration of SWS patients. These features must be addressed in order for the patients improve social interactions, obtain gainful employment and achieve a better quality of life. Tous les patients ont été examinés par un des auteurs (I.P -C). Résultats : Les manifestations les plus fréquentes et les plus sévères chez les patients atteints du SSW dans cette série de cas étaient l'épilepsie, l'hémiparésie, le retard mental et les problèmes oculaires. Le naevus flammeus facial était unilatéral chez 35 patients (63,5%) atteints d'angiomes des leptoméninges, bilatéral chez 17 patients (31%) et absent chez 3 patients (5,5%). Sept patients (41%) parmi les 17 patients atteints de naevus flammeus bilatéral avaient des angiomes leptoméningés unilatéraux. Quarante-sept patients (85,5%) présentaient des crises convulsives. Un contrôle absolu des crises a été obtenu chez 20 patients (42,5%). Cependant, chez 2 de ces patients les crises ont été contrôlées seulement après une lobectomie. Tous les patient...

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