Cavernous Angioma: A Review of 126 Collected and 12 New Clinical Cases

A 47-year-old woman presented with unilateral ventricular enlargement detected by magnetic resonance imaging during a medical checkup. Neuroendoscopic exploration identified a multilocular lesion in which dark red fluid formed a niveau near the right side of the foramen of Monro. The diagnosis was intraventricular cavernous angioma. Restricted flow of cerebrospinal fluid at the foramen of Monro was observed. Xanthochromia, which seemed to be due to previous bleeding, was observed at the fornix. When the neuroendoscope touched the angioma, the wall collapsed and bled. Endoscopic removal of the angioma was abandoned, and craniotomy and resection of the angioma were performed. No new neurological anomalies were observed after surgery. Preoperative diagnosis of intraventricular cavernous angioma is difficult based on neuroimaging. Neuroendoscopy is effective for diagnosis and the decision-making process regarding treatment.

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“…[4][5][6][7]9,10,14) Intraventricular cavernous angioma may account for 2.5-10.8% of all cavernous angiomas. 12,15) The 47…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscopic Appearance of an Intraventricular Cavernous Angioma Blocking the Foramen of Monro-Case Report-

Sato

Oka

Utsuki

et al. 2006

Neurol. Med. Chir.(Tokyo)

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“…Os cavernomas representam 5 a 16% das malformações vasculares intracranianas 13 . Eles são mais frequentemente encontrados na região subcortical dos hemisférios cerebrais, gânglios da base e ponte.…”

Section: Discussionunclassified

Ressonância magnética dos cavernomas intraventriculares: aspectos diagnósticos

Tatsui

Koerbel

Prevedello

et al. 2003

Arq. Neuro-Psiquiatr.

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RESUMO -Cavernomas são malformações vasculares que frequentemente acometem a substância branca dos hemisférios cerebrais e tronco encefálico. São angiograficamente ocultas e têm como principal método diagnóstico a ressonância magnética, em que tipicamente se observa nas sequências ponderadas em T2, um halo perilesional hipointenso devido a deposição de hemossiderina no tecido adjacente. A localização ventricular é considerada rara, e suas características de imagem na ressonância magnética diferem, podendo não apresentar tal halo. Apresentamos dois casos nos quais o diagnóstico foi feito somente com exame histopatológico, devido a ausência dos critérios de imagem que permitiriam a suspeita de tal lesão. Os cavernomas devem ser incluidos no diagnóstico diferencial dos processos expansivos intraventriculares, sendo a ressecção cirurgica completa a melhor modalidade de tratamento para estas lesões.PALAVRAS-CHAVE: hemangioma cavernoso, cavernoma, neoplasias ventriculares cerebrais, ressonância magnética, malformações arteriovenosas cerebrais.Magnetic resonance imaging of the intraventricular cavernomas: diagnostic aspects Magnetic resonance imaging of the intraventricular cavernomas: diagnostic aspects Magnetic resonance imaging of the intraventricular cavernomas: diagnostic aspects Magnetic resonance imaging of the intraventricular cavernomas: diagnostic aspects Magnetic resonance imaging of the intraventricular cavernomas: diagnostic aspects ABSTRACT -Cavernomas are vascular malformations that typically affect the white matter of cerebral hemispheres and brain stem. They are angiographically occult lesions that depend on magnetic resonance imaging (MRI) for their diagnosis, presenting a hypointense perilesional ring caused by hemossiderin deposition as seen in T2 sequences. The ventricular location is rare, and image features may differ. We present two cases with diagnosis made only by histopathologic examination, due to a lack of classic image findings. Cavernous hemangiomas must be included in the differential diagnosis of intraventricular tumors, and total surgical resection is the treatment of choice. Perilesional ring as demonstrated by MRI, must not be expected when dealing with such lesions. KEY WORDS: cavernous hemangioma, cavernoma, cerebral ventricle neoplasms, magnetic resonance, cerebral arteriovenous malformations. Malformações vasculares se originam a partir do desenvolvimento anômalo da rede vascular no tecido nervoso durante a fase embrionária. Elas são classificadas em 4 grupos, sendo os cavernomas ou angiomas cavernosos um dos subtipos 1 . Eles tipicamente são encontrados na região subcortical próxima à fissura silviana, nos gânglios da base e no tronco encefálico [2][3][4] . A sintomatologia dessas lesões depende de sua localização e a história natural dos cavernomas tem sido melhor caracterizada nos últimos anos, especialmente após o advento da ressonância magnética (RM) 5-8 .Até recentemente, haviam sido relatados 45 casos de cavernomas localizados no interior do sistema ventricular, em revisão...

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“…As has previously been reported concerning hematoma, depending upon the interval since bleeding, the hematoma can show increased or decreased signal intensity and the presence of an lesion of various signal intensities with a reticulated appearance suggests the coexistence of both old and new hematomas. Moreover, on T2 weighted images, an extremely decreased signal intensity ring, the so-called hemosiderin rim, is seen in the periphery of the hematoma (Simard et al 1986). This shows up most clearly on high-field strength MRI.…”

Section: Discussionmentioning

confidence: 99%