1/44. Intracranial cavernomas: indications for and results of surgery.Between April 1991 and April 1997, 46 patients were treated in our department presenting with intracranial cavernomas. Initial symptoms were focal seizures, bleeding episodes, and/or headaches. Mean age was 41 year (range 9 to 68 years). There were 24 female and 22 male patients. Computed tomography and magnetic resonance imaging were performed in order to establish the diagnosis, angiography was only indicated when the hemorrhaged area was so close to the subarachnoid space in the vicinity of the basal cisterns that an aneurysm had to be ruled out. Aggressive indication for surgery also in brainstem cavernomas was based on the natural history of the lesion, since the majority of patients presenting with intracranial bleeding had suffered several (up to six) episodes of previous hemorrhages. patients' clinical status upon admission and accessibility of the cavernoma were taken into account for planning the operation. The operative planning and approach were greatly facilitated by using a neuronavigational device and intraoperative electrophysiological monitoring particularly in cavernomas located in the brainstem, thalamus, and medulla oblongata. Surgical removal of the lesions resulted in a new permanent neurological deficit only in two patients (4%). These data show that patients benefit from modern neurosurgical techniques in contrast to conservative approach in this disease of rather prolonged natural course.- - - - - - - - - - ranking = 1keywords = subarachnoid (Clic here for more details about this article) |
2/44. Superficial siderosis of the CNS associated with multiple cavernous malformations.Superficial siderosis of the CNS due to chronic, recurrent subarachnoid hemorrhage is an uncommon and potentially debilitating disorder. The classic clinical manifestation is progressive bilateral sensorineural hearing loss (SNHL), although ataxia and pyramidal signs also are observed frequently. Cavernous malformations rarely present with subarachnoid hemorrhage. We describe an unusual case of a young patient who presented with progressive, bilateral SNHL who was found to have superficial CNS siderosis associated with multiple cavernous malformations.- - - - - - - - - - ranking = 2keywords = subarachnoid (Clic here for more details about this article) |
3/44. prenatal diagnosis of fetal cerebellar lesions: a case report and review of the literature.The fetal cerebellar structure, size and consistency are looked at in every system survey. Among the acquired cerebellar events that might change the cerebellar consistency are haemorrhage, infections in utero and neoplasia. Additional fetal malformations, if present, assist in making the final diagnosis. We present a case of an isolated echogenic mass in one of the cerebellar hemispheres along with the differential diagnosis.- - - - - - - - - - ranking = 3.0451689967817keywords = haemorrhage (Clic here for more details about this article) |
4/44. Multiple calvarial haemangiomas.Calvarial haemangiomas are rare benign tumours that may be suspected by their characteristic expansile 'sunburst' appearance. It is important to recognize them as such and to make the surgeon aware of haemorrhage after biopsy or resection.- - - - - - - - - - ranking = 3.0451689967817keywords = haemorrhage (Clic here for more details about this article) |
5/44. Cavernous haemangioma of the retina and optic disc. A report of three cases and a review of the literature.We report characteristics of three cases of cavernous haemangioma of the retina, bringing to 37 the number now reported in the available literature. This rare, benign, congenital malformation is non-progressive, usually unilateral, somewhat more frequent in women, and rarely a source of intraocular haemorrhage. The fluorescein angiographic features include a normal arterial and venous supply, extraordinarily slowed venous drainage, no arterio-venous shunting, no disturbances of vascular permeability, and no secondary retinal exudation. Almost always, isolated clusters of vascular globules with plasma/erythrocyte sedimentation surround the main body of the malformation. These findings differentiate the anomaly from other retinal vascular diseases. Therapeutic intervention is seldom necessary.- - - - - - - - - - ranking = 3.0451689967817keywords = haemorrhage (Clic here for more details about this article) |
6/44. Identification of an arteriovenous fistula in a child. Case report and review of the literature.BACKGROUND: A 6-year-old girl sustained a subarachnoid hemorrhage after a mild head injury and was discovered to have an arteriovenous fistula (AVF). INVESTIGATIONS AND TREATMENT: The etiology of subarachnoid hemorrhage was not evident on the initial brain CT. brain CT with CT angiography identified the lesion. The AVF was further imaged with brain MRI followed by cerebral angiography and successfully embolized. OUTCOME: The child did not suffer any neurological sequelae.- - - - - - - - - - ranking = 2keywords = subarachnoid (Clic here for more details about this article) |
7/44. Bleeding from a cavernous angioma mimicking rupture of a middle cerebral artery aneurysm.Cavernous angiomas and aneurysms may both present with acute cerebral haemorrhage. We present a case in which the coexistence of an unruptured aneurysm obscured the diagnosis of cerebral haemorrhage from a cavernous angioma. Although this association was presumably coincidental, this case demonstrates that obvious pathology (an angiographically proven aneurysm at the site of haemorrhage) may reduce awareness of other, possibly more common, causes of cerebral haemorrhage.- - - - - - - - - - ranking = 12.180675987127keywords = haemorrhage (Clic here for more details about this article) |
8/44. Superficial siderosis of the central nervous system: pathogenetic heterogeneity and therapeutic approaches.OBJECTIVE: Superficial siderosis of the central nervous system (CNS) is a rare chronic progressive disorder caused by chronic subarachnoid hemorrhage. We present four patients with superficial siderosis of the CNS to describe the characteristic symptoms, and to discuss the pathogenetic heterogeneity and possible new therapeutic approaches. RESULTS: The causes of chronic subarachnoid bleeding in superficial siderosis were different. In two patients surgical treatment of ependymoma or cerebral cavernomas were the underlying diseases. No cause was detected in one patient. For the first time, we present one patient with vasculitis of the central nervous system associated with systemic hemochromatosis in superficial siderosis. Therapeutic approaches included exstirpation of cavernomas as the source of chronic bleeding in one patient, immunosuppressive therapy and venupunctures in the patient with vasculitis and hemochromatosis, and symptomatic treatment with chelating agents and antioxidants. The patients remained clinically stable for the follow-up period of up to 2 years. CONCLUSIONS: Our cases underline the pathogenetic heterogeneity of superficial siderosis and favor the early diagnosis for prompt initiation of therapy. Besides treatment of the underlying condition, antioxidants and radical scavengers may be effective in halting the progression of the disease.- - - - - - - - - - ranking = 2keywords = subarachnoid (Clic here for more details about this article) |
9/44. Cerebral cavernous haemangiomas or cavernomas. incidence, pathology, localization, diagnosis, clinical features and treatment. review of the literature and report of an unusual case.Reviewing the literature and adding one unusual case the features of 164 cerebral cavernous haemangiomas are described with special reference to incidence, localization, diagnosis and clinical findings. Cavernomas may be found in every age group including the neonatal period. The sex incidence is equal. In 126 cases (76.8%) the cavernomas were of supratentorial, in 34 cases (20.7%) of infratentorial site, and in 4 more cases (2.5%) there was multiple occurence of supratentorial and posterior fossa cavernous haemangiomas. A specific clinical syndrome could not be defined: but the course is usually acute or subacute, and initial symptoms are commonly epileptic fits, acute headache and subarachnoid or intracerebral haemorrhage. Macroscopic calcifications of cerebral cavernomas were found only in 18 cases (11%). cerebral angiography was done in 31 cases (18.9%). In 9 cases angiography was totally normal, and in 11 cases the cavernoma presented only as an avascular mass. In the remaining cases there was no conformity in the angiographic appearance of cerebral cavernous haemangiomas. Operative extirpation is the treatment of choice if a solitary lesion is favourably located. In addition to our patient there are now 21 cases (12.8%) in which cavernomas were treated successfully by operative extirpation.- - - - - - - - - - ranking = 4.0451689967817keywords = haemorrhage, subarachnoid (Clic here for more details about this article) |
10/44. Controversies in the management of brainstem cavernous angioma: report of two cases.Two cases of cavernous angioma involving the medulla oblongata are presented. Both cases underwent surgical excision with excellent outcome. The use of surgery via craniectomy is contrasted with stereotactic radiosurgery in light of the known natural history of the lesions. As a result, it is suggested that surgical excision provides immediate protection from the risks of recurrent haemorrhage, establishes a tissue diagnosis, allows complete removal at the primary intervention, avoids complications of radiation-induced damage and is performed more easily in these vascular anomalies due to the presence of a capsule with surrounding gliotic tissue. Additionally, it is implied that the natural history of lesions in this region is still unclear. For these reasons, it is suggested that surgical excision should be the primary therapeutic intervention for cavernous angiomata that involve the brainstem.- - - - - - - - - - ranking = 3.0451689967817keywords = haemorrhage (Clic here for more details about this article) |
| | Next -> |