INTRODUCTION:Venous malformations are the most frequent vascular malformation. Deep venous malformations are located in subcutaneous tissue or in the muscles. Percutaneous sclerotherapy is the treatment of choice, and the use of ethanol at low doses has not yet been described.OBJECTIVE:To analyze the results of treating Deep venous malformations patients with low doses of ethanol.METHODS:Thirty‐nine patients treated between July 1995 and June 2007 were followed up prospectively over a median period of 18 months. Twenty‐nine were female (74.4%) and 10 were male (25.6%), with ages ranging from 11 to 59 years (median of 24 years). All of the lesions affected limbs, and the main symptom reported was pain (97.4%). Each patient underwent fortnightly alcohol application sessions under local anesthesia on an outpatient basis. The lesions were classified into three groups according to size using nuclear magnetic resonance imaging: small, up to 3 cm (4 patients); medium, between 3 and 15 cm (27 patients); and large, greater than 15 cm (8 patients).RESULTS:The symptoms completely disappeared in 14 patients (35.9%) and improved in 24 (61.5%). The lesion size reduced to zero in 6 patients (15.4%) and decreased in 32 (82%). The median number of sessions was 7. There were no complications in 32 patients (82%), while 3 presented local paresthesia (7.7%), 2 superficial trombophlebites (5.1%), 1 skin ulcer (2.6%), and 1 case of hyperpigmentation (2.6%).CONCLUSION:Outpatient treatment for Deep venous malformations patients using ethanol at low doses was effective, with a low complication rate.
Background: Superficial venous malformations (SVM) are the most frequent vascular malformations. Outpatient percutaneous treatment with ethanol injection has rarely been described. Objective: To analyze the results from treating SVM patients with ethanol sclerotherapy. Methods: 81 patients were followed up prospectively over a median period of 18 months. 47 were female and 34 were male with a median age of 21 years. Most of the lesions were located in the limbs and the main symptom reported was pain. Each patient underwent fortnightly alcohol injection sessions. Results: The lesions and the symptoms completely disappeared or improved in 77 patients. There were no complications in 64 patients, while 11 presented a small skin ulcer, 3 hyperpigmentation and 3 paresthesia. Conclusion: Ethanol sclerotherapy for SVM patients was effective, with a low complication rate.
Objective:This retrospective study evaluated the results of sclerotherapy with low doses of ethanol for treatment of head and neck venous malformations.Methods:We treated 51 patients, 37 females. Median age was 23 years. Patients were treated with percutaneous intralesional injection of alcohol every two weeks and followed up prospectively for a median period of 18 months. Most lesions affected the face and cosmetic disfigurement was the most frequent complaint.Results:We performed a median of 7 sessions of sclerotherapy. Complete resolution or improvement was observed in 48 patients presented. Five cases of small skin ulceration, two cases of hyperpigmentation and two of paresthesia were documented; all of them were treated conservatively.Conclusion:Percutaneous sclerotherapy with low doses of ethanol is a safe and effective treatment modality for venous malformations affecting the head and neck.
In an attempt to further define the optimum target for abolishing tremor, 25 cases out of a series of 1,000 consecutive thalamotomies for Parkinson''s disease were selected on the basis that mere impact of electrode placement had suddenly arrested tremor. These sites were carefully plotted, and correlated with the available data from physiological exploration. They were grouped in a relatively restricted area, extended from 2 to 8 mm in front of PC, from 8 mm above to 2 mm below the AC-PC line in the sagittal plane, and from 13 to 15 mm laterally, but densely in its posterio-inferior part. There is a soma-totopic arrangement, since tremor is sometimes exclusively arrested in one limb. These sites correspond to the area from where Gillingham and others reported rhythmic bursting activity synchronous with tremor. Stimulation with low frequency produced an increase or activation of tremor, and with higher frequencies, amelioration or suppressive response. In all cases, the radiofrequency lesion at this site produced a long-lasting relief of tremor, with no side effects. This area corresponded to the prelemniscal radiation and lemniscal sector of V.c.p., V.i.m. and posterior-basal part of V.o.p
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