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Patel M, Mahajan U, Pace J, Rothstein B. Presentation and management of nervous system cavernous malformations in children: A systematic review and case report. Brain Circ 2022; 8:121-126. [PMID: 36267435 PMCID: PMC9578313 DOI: 10.4103/bc.bc_26_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/09/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022] Open
Abstract
Cerebral cavernous malformations (CMs) are slow-flow vascular lesions that affect up to 0.5% of the pediatric population. These lesions are at risk for hemorrhage, causing seizures, and leading to neurological deficits. Here, we conduct a literature review and then present a report of a supratentorial CM in a 2-year-old patient with no significant past medical history who presented at our institution with 1 month of eye twitching. We performed a literature search of five databases of all articles published before 2020. Our inclusion criteria included cohort and case series of children with mean age under 12 years. Our search yielded 497 unique articles, of which 16 met our inclusion criteria. In our pooled literature analysis, a total of 558 children were included, 8.3% of which had a positive family history and 15.9% had multiple CMs. About 46.1% of the children had seizures, and 88.4% of those who underwent surgery had a total resection. About 85.1% of those with epilepsy were Engel Class 1 postsurgery. Over a mean follow-up of 4.1 years, 3.4% of patients had additional neurological deficits, including paresis and speech deficits. Our analysis of published literature shows surgical intervention should be considered first-line therapy for patients who are symptomatic from CM, present with seizure, and have surgically accessible lesions. Additional work is needed on outcomes and long-term effects of minimally invasive treatments, including radiosurgery and laser ablation, in pediatric populations.
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Bergametti F, Viot G, Verny C, Brechard MP, Denier C, Labauge P, Petit P, Nouet A, Viallet F, Chaussenot A, Hervé D, Tournier-Lasserve E, Riant F. Novel CCM2 missense variants abrogating the CCM1-CCM2 interaction cause cerebral cavernous malformations. J Med Genet 2020; 57:400-404. [PMID: 31937560 DOI: 10.1136/jmedgenet-2019-106401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/20/2019] [Accepted: 12/21/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cerebral cavernous malformations (CCMs) are vascular malformations mostly located within the central nervous system. Most deleterious variants are loss of function mutations in one of the three CCM genes. These genes code for proteins that form a ternary cytosolic complex with CCM2 as a hub. Very few CCM2 missense variants have been shown to be deleterious by modifying the ternary CCM complex stability. OBJECTIVES To investigate the causality of novel missense CCM2 variants detected in patients with CCM. METHODS The three CCM genes were screened in 984 patients referred for CCM molecular screening. Interaction between CCM1 and CCM2 proteins was tested using co-immunoprecipitation experiments for the CCM2 missense variants located in the phosphotyrosine binding (PTB) domain. RESULTS 11 distinct CCM2 rare missense variants were found. Six variants predicted to be damaging were located in the PTB domain, four of them were novel. When co-transfected with CCM1 in HEK293T cells, a loss of interaction between CCM1 and CCM2 was observed for all six variants. CONCLUSION We showed, using co-immunoprecipitation experiments, that CCM2 missense variants located in the PTB domain were actually damaging by preventing the normal interaction between CCM1 and CCM2. These data are important for diagnosis and genetic counselling, which are challenging in patients harbouring such variants.
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Affiliation(s)
| | - Geraldine Viot
- Unité de Génétique, Hopital Americain de Paris, Neuilly-sur-Seine, Île-de-France, France
| | - Christophe Verny
- Service de Neurologie, CHU Angers, Angers, Pays de la Loire, France
| | - Marie Pierre Brechard
- Service de Génétique Médicale, Hopital Saint Joseph, Marseille, Provence-Alpes-Côte d'Azur, France
| | - Christian Denier
- Département de Neurologie, Hospital Bicetre, Le Kremlin-Bicetre, Île-de-France, France
| | - Pierre Labauge
- Service de Neurologie, CHRU de Montpellier, Montpellier, Languedoc-Roussillon, France
| | - Paul Petit
- Cabinet de Neurologie - Cabestan, Cabestan, France
| | - Aurélien Nouet
- Service de Neurochirurgie, Hopital Universitaire Pitie Salpetriere, Paris, Île-de-France, France
| | - François Viallet
- Service de Neurologie, CH intercommunal Aix-Pertuis, Aix en Provence, France
| | - Annabelle Chaussenot
- Service de Génétique Médicale, Hopital de l'Archet, Nice, Provence-Alpes-Côte d'Azur, France
| | - Dominique Hervé
- Service de Neurologie, GH Saint Louis - Lariboisiere - Fernand Widal, Paris, Île-de-France, France.,Centre de Référence pour les Maladies Rares des Vaisseaux du Cerveau et de l'Oeil (CERVCO), GH Saint Louis - Lariboisiere - Fernand Widal, Paris, Île-de-France, France
| | - Elisabeth Tournier-Lasserve
- UMR-S1141, INSERM, Paris, Île-de-France, France.,Centre de Référence pour les Maladies Rares des Vaisseaux du Cerveau et de l'Oeil (CERVCO), GH Saint Louis - Lariboisiere - Fernand Widal, Paris, Île-de-France, France.,Service de Génétique Moléculaire Neurovasculaire, GH Saint Louis - Lariboisière - Fernand Widal, Paris, Île-de-France, France
| | - Florence Riant
- UMR-S1141, INSERM, Paris, Île-de-France, France .,Centre de Référence pour les Maladies Rares des Vaisseaux du Cerveau et de l'Oeil (CERVCO), GH Saint Louis - Lariboisiere - Fernand Widal, Paris, Île-de-France, France.,Service de Génétique Moléculaire Neurovasculaire, GH Saint Louis - Lariboisière - Fernand Widal, Paris, Île-de-France, France
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Yu W, Jin H, You Q, Nan D, Huang Y. A novel PDCD10 gene mutation in cerebral cavernous malformations: a case report and review of the literature. J Pain Res 2019; 12:1127-1132. [PMID: 31114296 PMCID: PMC6497854 DOI: 10.2147/jpr.s190317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/14/2019] [Indexed: 12/24/2022] Open
Abstract
Cerebral cavernous malformations (CCMs) are one of the most common types of vascular malformation, which are featured enlarged and irregular small blood vessels. The cavernous cavities are merely composed of a single layer of endothelial cells and lack other support tissues, such as elastic fibers and smooth muscle, which make them elastic. CCMs may develop in sporadic or familial forms with autosomal dominant inheritance. Mutations have been identified in three genes: KRIT1, MGC4607, and PDCD10. Here, we report a typical case of CCMs in a 44-year-old woman associated with a novel mutation in PDCD10 gene. The patient, diagnosed with CCMs, has been suffering from headache for several months. Analyses of the Whole Exome Sequencing revealed a novel disease-associated mutation in the already known disease-associated PDCD10 gene. This mutation consists a nucleotide deletion (c.212delG) within the exon 4, resulting in premature protein termination (p.S71Tfs*18). This novel mutation significantly enriches the spectrum of mutations responsible for CCMs, providing a new evidence for further clarifying the genotype-phenotype correlations in CCMs patients.
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Affiliation(s)
- Weiwei Yu
- Department of Neurology, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Haiqiang Jin
- Department of Neurology, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Qian You
- Department of Neurology, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Ding Nan
- Department of Neurology, Peking University First Hospital, Beijing 100034, People's Republic of China
| | - Yining Huang
- Department of Neurology, Peking University First Hospital, Beijing 100034, People's Republic of China
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Cigoli MS, De Benedetti S, Marocchi A, Bacigaluppi S, Primignani P, Gesu G, Citterio A, Tassi L, Mecarelli O, Pulitano P, Penco S. A Novel MGC4607/CCM2 Gene Mutation Associated with Cerebral Spinal and Cutaneous Cavernous Angiomas. J Mol Neurosci 2015; 56:602-7. [PMID: 25869611 DOI: 10.1007/s12031-015-0555-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
Abstract
Cerebral cavernous malformations (CCMs) are vascular abnormalities that may cause seizures, headaches, intracerebral hemorrhages, and focal neurological deficits; they can also be clinically silent and occur as a sporadic or an autosomal dominant condition. Three genes have been identified as causing familial CCM: KRIT1/CCM1, MGC4607/CCM2, and PDCD10/CCM3, mapping, respectively, on chromosomes 7q, 7p, and 3q. Here, we report an Italian family affected by CCM due to a MGC4607 gene mutation, on exon 4. All the affected subjects suffered from seizures, and some of them underwent surgery for removal of a cavernous angioma. Brain MRI showed multiple lesions consistent with CCMs in all patients. Spinal and cutaneous cavernous angiomas were present too. This report underlines the need for a careful interdisciplinarity among neurologists, neuroradiologists, neurosurgeons, geneticists, ophthalmologists, and dermatologists for a total evaluation of the different manifestations of familial CCM. This points out that only referral centers are organized to offer a multidisciplinary management of this disease.
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Affiliation(s)
- M S Cigoli
- Department of Laboratory Medicine - Medical Genetics Unit, Niguarda Ca' Granda Hospital, Milano, Italy
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PDCD10 gene mutations in multiple cerebral cavernous malformations. PLoS One 2014; 9:e110438. [PMID: 25354366 PMCID: PMC4212902 DOI: 10.1371/journal.pone.0110438] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/22/2014] [Indexed: 11/19/2022] Open
Abstract
Cerebral cavernous malformations (CCMs) are vascular abnormalities that may cause seizures, intracerebral haemorrhages, and focal neurological deficits. Familial form shows an autosomal dominant pattern of inheritance with incomplete penetrance and variable clinical expression. Three genes have been identified causing familial CCM: KRIT1/CCM1, MGC4607/CCM2, and PDCD10/CCM3. Aim of this study is to report additional PDCD10/CCM3 families poorly described so far which account for 10-15% of hereditary cerebral cavernous malformations. Our group investigated 87 consecutive Italian affected individuals (i.e. positive Magnetic Resonance Imaging) with multiple/familial CCM through direct sequencing and Multiplex Ligation-Dependent Probe Amplification (MLPA) analysis. We identified mutations in over 97.7% of cases, and PDCD10/CCM3 accounts for 13.1%. PDCD10/CCM3 molecular screening revealed four already known mutations and four novel ones. The mutated patients show an earlier onset of clinical manifestations as compared to CCM1/CCM2 mutated patients. The study of further families carrying mutations in PDCD10/CCM3 may help define a possible correlation between genotype and phenotype; an accurate clinical follow up of the subjects would help define more precisely whether mutations in PDCD10/CCM3 lead to a characteristic phenotype.
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Bacigaluppi S, Retta SF, Pileggi S, Fontanella M, Goitre L, Tassi L, La Camera A, Citterio A, Patrosso MC, Tredici G, Penco S. Genetic and cellular basis of cerebral cavernous malformations: implications for clinical management. Clin Genet 2013; 83:7-14. [DOI: 10.1111/j.1399-0004.2012.01892.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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