Pathological Changes in Surgically Resected Cystic Cerebral Cavernous Malformation 13 Years After Radiosurgery: Case Report and Review of the Literature

Wang, Chao; Yu, Bing; Zhang, Fengyue; Zheng, Kaijian; Feng, Yugong

doi:10.1016/j.wneu.2020.07.042

Cited by 3 publications

(2 citation statements)

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“…4 However, it is also known that the cyst wall consists of neocapillaries and is lined by endothelium-derived cells, which can lead to reaccumulation of the cyst and lesion recurrence; hence, its complete removal is suggested if it is easily possible and an appropriate plane of dissection is obtained. 15,45 In our literature review of 52 patients with cCCMs, gross total excision was reported in 36 (69.23%) patients, subtotal/partial resection was reported in 2 (3.85%) patients, and the extent of resection was not reported in the remaining 14 (26.93%) patients.…”

Section: Discussionmentioning

confidence: 92%

“… 29 36 Based on our limited experience, we believe it is a combination of multiple factors that leads to cyst formation. 15 45 As far as the risk of rebleeding is concerned, the cyst wall may indeed contain the malformation that most likely led to a re-bleed in patient no. 3, and a small remnant of the cyst was noted intraoperatively and subsequently excised.…”

Section: Discussionmentioning

confidence: 99%

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Cystic Cerebral Cavernous Malformations: Report of Five Cases and a Review of Literature

et al. 2023

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Introduction Cerebral cavernous malformations (CCMs) account for about 5 to 13% of intracranial vascular malformations. Cystic cerebral cavernous malformations (cCCMs) are a rare morphological variant and can cause diagnostic and therapeutic dilemmas. We describe our five such cases and review the existing literature on this entity. Methods A search of the PubMed database for cCCMs was done, and all articles in English emphasizing the reporting of cCCMs were selected. A total of 42 publications describing 52 cases of cCCMs were selected for analysis. Epidemiological data, clinical presentation, imaging features, the extent of resection, and outcome were analyzed. Radiation-induced cCCMs were excluded. We have also described five of our cases of cCCMs and reported our experience. Results The median age at presentation was 29.5 years. Twenty-nine patients had supratentorial lesions, 21 had infratentorial lesions, and 2 had lesions in both compartments. Among our four patients, three had infratentorial lesions, whereas one had a supratentorial lesion. Multiple lesions were seen in four patients. A majority (39) had symptoms of mass effect (75%), and 34 (65.38%) had raised intracranial pressure (ICP), whereas only 11 (21.15%) had seizures. Among our four operated patients, all of them had symptoms of mass effect, and two of them also had features of raised ICP. The extent of resection was gross total in 36 (69.23%), subtotal in 2 (3.85%), and not reported in 14 (26.93%). All four of our operated patients underwent gross total resection, but two of them underwent a second surgery. Of the 48 patients in whom the surgical outcome was reported, 38 improved (73.08%). One showed a transient worsening followed by improvement, one developed a worsening of the pre-existing focal neurological deficit (FND), two developed a new FND, and 5 had no improvement in their FNDs. Death occurred in one patient. All four of our operated patients improved after surgery, although three of them showed a transient worsening of FNDs. One patient is under observation. Conclusion cCCMs are rare morphological variants and can cause considerable diagnostic and therapeutic dilemmas. They should be considered in the differential diagnosis of any atypical cystic intracranial mass lesion. Complete excision is curative, and the outcome is generally favorable; although transient deficits may be seen.

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Section: Discussionmentioning

confidence: 92%