1
|
Thomas AP, Velayudhan SC, John TR, Sudhakaran P. A Case of Reversible Paraplegia due to Multiple Intraspinal and Intracranial Cavernomas. Neurol India 2024; 72:443-444. [PMID: 38691501 DOI: 10.4103/ni.neurol-india-d-23-00554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/23/2023] [Indexed: 05/03/2024]
Affiliation(s)
- Ann P Thomas
- Department of Neurology, Government TD Medical College, Alappuzha, Kerala, India
| | - Shaji C Velayudhan
- Department of Neurology, Government TD Medical College, Alappuzha, Kerala, India
| | - Tisa R John
- Department of Radiodiagnosis, Government TD Medical College, Alappuzha, Kerala, India
| | - Prasanth Sudhakaran
- Department of Neurology, Government TD Medical College, Alappuzha, Kerala, India
| |
Collapse
|
2
|
Gomathy SB, Das A, Garg A, Srivastava AK. Disseminated Cavernous Malformations Due to KRIT1 Gene Mutation Causing Seizure and Spastic Paraparesis. Ann Indian Acad Neurol 2024; 27:92-94. [PMID: 38495229 PMCID: PMC10941907 DOI: 10.4103/aian.aian_688_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 03/19/2024] Open
Affiliation(s)
- Saranya B. Gomathy
- Department of Neurology, Sree Chitra Institute for Medical Sciences and Technology, Kerala, India
| | - Animesh Das
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Garg
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Achal K. Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
3
|
Izi Z, El Haddad S, Allali N, Chat L. Spinal Cord Cavernous Malformation: A Case Report. Glob Pediatr Health 2023; 10:2333794X231184317. [PMID: 37434870 PMCID: PMC10331179 DOI: 10.1177/2333794x231184317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/13/2023] Open
Abstract
Spinal cord cavernous malformation is a rare and uncommon vascular malformation, it may remain asymptomatic for a long period or manifest as a sudden or gradual change in spinal cord functioning. The diagnosis relies essentially on magnetic resonance imaging (MRI). Surgery constitutes the majority of management with all the complications that can occur during and after surgery. We report a case of intramedullary cavernoma of a 12-year-old patient admitted for acute paraparesia with bowel and bladder dysfunction. MRI revealed 2 intramedullary cavernomas at T6-T7 and T11-T12. Through this case report, we discuss the clinical and radiological characteristics of this unusual intramedullary malformation.
Collapse
|
4
|
Spinal involvement in pediatric familial cavernous malformation syndrome. Neuroradiology 2022; 64:1671-1679. [PMID: 35451625 DOI: 10.1007/s00234-022-02958-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of the study was to assess the prevalence and characteristics of spinal cord cavernous malformations (SCCM) and intraosseous spinal vascular malformations (ISVM) in a pediatric familial cerebral cavernous malformation (FCCM) cohort and evaluate clinico-radiological differences between children with (SCCM +) and without (SCCM-) SCCM. METHODS All patients with a pediatric diagnosis of FCCM evaluated at three tertiary pediatric hospitals between January 2010 and August 2021 with [Formula: see text] 1 whole spine MR available were included. Brain and spine MR studies were retrospectively evaluated, and clinical and genetic data collected. Comparisons between SCCM + and SCCM- groups were performed using student-t/Mann-Whitney or Fisher exact tests, as appropriate. RESULTS Thirty-one children (55% boys) were included. Baseline spine MR was performed (mean age = 9.7 years) following clinical manifestations in one subject (3%) and as a screening strategy in the remainder. Six SCCM were detected in five patients (16%), in the cervico-medullary junction (n = 1), cervical (n = 3), and high thoracic (n = 2) regions, with one appearing during follow-up. A tendency towards an older age at first spine MR (P = 0.14) and [Formula: see text] 1 posterior fossa lesion (P = 0.13) was observed in SCCM + patients, lacking statistical significance. No subject demonstrated ISVM. CONCLUSION Although rarely symptomatic, SCCM can be detected in up to 16% of pediatric FCCM patients using diverse spine MR protocols and may appear de novo. ISVM were instead absent in our cohort. Given the relative commonality of asymptomatic SCCM, serial screening spine MR should be considered in FCCM starting in childhood.
Collapse
|
5
|
Yang P, Li Y, Liu HC, Qiu E, Zhang JL, Ren J, Jiang LB, Liu HG, Kang J. Prognosis Analysis and Clinical Features of Orbital Cavernous Venous Malformations With Refractory Insidious Onset. Front Oncol 2022; 11:745479. [PMID: 35178343 PMCID: PMC8844367 DOI: 10.3389/fonc.2021.745479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/27/2021] [Indexed: 11/16/2022] Open
Abstract
Objective The present study aims to analyse the clinical presentation, treatment and prognosis of a group of patients with orbital cavernous venous malformation (OCVM) with an insidious onset. Method The clinical data of 35 patients with OCVM treated at our centre between 2003 and 2020 were retrospectively analysed. The OCVMs were classified as one of six types (I–VI) according to the orbital position of the tumour. The clinical characteristics, treatment methods and follow-up results were recorded. Results A total of 35 patients with OCVM under the optic nerve sheath in the orbital apex area or the common tendon ring (Types I and II) were included in the present study. In 20 cases (57.1%), patients were misdiagnosed with optic neuritis, and in 20 cases (57.1%), the tumour was not identified based on imaging. The presentation was acute or subacute in 23 cases (65.7%). All patients underwent surgery: transnasal surgery in 22 cases (62.9%) and craniotomy in 13 cases (37.1%). A total of 9 patients (25.7%) experienced postoperative complications, and 17 patients (48.6%) experienced vision improvement. The average patient age at first diagnosis was 43.3 ± 10.3 years, and the median follow-up period was 64.5 months. Overall, 14 patients (40%) experienced postoperative complications: postoperative blindness in 6 cases, postoperative vision loss in 8 cases and orbital apex syndrome in 7 cases. Conclusion Patients with Type I and Type II OCVMs are the most complex cases. They have an insidious onset and are associated with a high rate of misdiagnosis and missed diagnosis. Acute and subacute decreases in visual acuity are mainly caused by OCVM haemorrhage. The difficulty of surgical treatment and the poor prognosis of postoperative vision are characteristics of this tumour. Transnasal surgery and craniotomy can be used to remove OCVMs located in the common tendon ring or optic canal as well as those involving the intracranial area through the supraorbital fissure. Meanwhile, the orbital approach (orbitotomy) has proven to be an effective method of treating OCVMs not involving the deep orbital apex and intracranial area.
Collapse
Affiliation(s)
- Peng Yang
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yong Li
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hao-Cheng Liu
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - E Qiu
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jia-Liang Zhang
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jian Ren
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li-Bin Jiang
- Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hong-Gang Liu
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jun Kang
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Mabray MC, Starcevich J, Hallstrom J, Robinson M, Bartlett M, Nelson J, Zafar A, Kim H, Morrison L, Hart BL. High Prevalence of Spinal Cord Cavernous Malformations in the Familial Cerebral Cavernous Malformations Type 1 Cohort. AJNR Am J Neuroradiol 2020; 41:1126-1130. [PMID: 32467184 DOI: 10.3174/ajnr.a6584] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/19/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Cavernous malformations occur most often in the brain but can occur in the spinal cord. Small studies of patients with familial cerebral cavernous malformations suggested a prevalence of spinal cord cavernous malformations of 20%-42%. We aimed to review our familial cohort and prospectively estimate the prevalence of spinal cord cavernous malformations. MATERIALS AND METHODS We initially reviewed our familial cerebral cavernous malformations cohort for spinal cord cavernous malformations and reviewed clinical spine MR imaging examinations for sequence sensitivity. We then prospectively performed research MR imaging of the spinal cord in 29 patients from the familial cohort to estimate the prevalence. RESULTS Gradient-based sequences identified the most spinal cord cavernous malformations on clinical MR images, forming the basis for developing our screening MR imaging. Screening spinal cord MR imaging demonstrated a prevalence of 72.4%, and a positive correlation with patient age and number of cerebral cavernous malformations. CONCLUSIONS Spinal cord cavernous malformations occur commonly in the familial cerebral cavernous malformation population. Gradient-based sequences are the most sensitive and should be used when spinal cord cavernous malformations are suspected. This study establishes the prevalence in the familial population at around 70% and supports the idea that this condition is a progressive systemic disease that affects the entire central nervous system.
Collapse
Affiliation(s)
- M C Mabray
- From the Departments of Radiology (M.C.M., J.S., J.H., B.L.H.)
| | - J Starcevich
- From the Departments of Radiology (M.C.M., J.S., J.H., B.L.H.)
| | - J Hallstrom
- From the Departments of Radiology (M.C.M., J.S., J.H., B.L.H.)
| | - M Robinson
- Neurology (M.R., M.B., A.Z., L.M.), University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - M Bartlett
- Neurology (M.R., M.B., A.Z., L.M.), University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - J Nelson
- Departments of Anesthesia and Perioperative Care, Center for Cerebrovascular Research (J.N., H.K.)
| | - A Zafar
- Neurology (M.R., M.B., A.Z., L.M.), University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - H Kim
- Departments of Anesthesia and Perioperative Care, Center for Cerebrovascular Research (J.N., H.K.).,Epidemiology and Biostatistics (H.K.), University of California San Francisco, San Francisco, California
| | - L Morrison
- Neurology (M.R., M.B., A.Z., L.M.), University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - B L Hart
- From the Departments of Radiology (M.C.M., J.S., J.H., B.L.H.)
| |
Collapse
|