Histologically Classified Venous Angiomas of the Brain: A Controversy.

Abstract

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.

Descriptive Epidemiology of Pediatric Intracranial Neoplasms in Egypt

“…Consistent with the vast majority of international studies [11,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30], a slight male predominance of childhood intracranial tumors (M/F = 1.04) was noted in our Egyptian referral center. In this context, Rickert and Paulus [5], in their meta-analysis of 10,582 childhood brain tumors accumulated from 16 international surveys, reported that the M/F ratio was 1.29.…”

“…In accordance with this result, MC tumors accounted for 3.7% in the Brain Tumor Registry of Japan [18] and 3% in the US Childhood Brain Tumor Consortium [30]. Tumors involving more than one compartment were not recognized in most previous studies due to a lack of detailed radiological descriptions in most reported surveys.…”

“…On the other hand, a different pattern is recognized in East Asian countries, where ST tumors predominate in all age groups in Japan [18], in all age groups except for the first 3 years of life in China [19] and in all age groups except the 5- to 9-year age group in Taiwan [20]. During adolescence (15–19 years), a clear ST predominance is evident, as it is in adulthood [5,18,30]. …”

Pathomechanisms of Symptomatic Developmental Venous Anomalies

“…In comparison to normal veins, histologically, DVAs are characterized by a composition of thin-walled vessels spread in normal neural parenchyma draining into a large caliber vein with a thicker wall 6 without a smooth muscle layer nor elastic lamina. 38 On contrast-enhanced CT, the venous collector of the DVA is readily detectable as a linear or curvilinear focus of enhancement, typically coursing from the deep white matter to a cortical vein or a deep vein or to a dural sinus. On MRIs, DVAs typically have a transhemispheric flow void on both T1-and T2-weighted images.…”

Hemodynamic Effects of Developmental Venous Anomalies with and without Cavernous Malformations

“…Given that the medullary veins composing the tributaries of the DVA are also known to have thinner walls, such veins may be more prone to bleed with this local venous hypertension. 20 DVAs generally fill later in the venous phase on catheter angiography. Our find- …”