Angioma cavernoso intracraniano

Lynch, José Carlos; Andrade, Ricardo; Pereira, Celestino; Salomão, J. Francisco; Duarte, Francisco; Carvalho, Francisca Gonçalves; Chadrycki, Edla

doi:10.1590/S0004-282X1994000200015

Resumos

Os autores apresentam dados clínicos, achados radiológicos, aspectos histopatológicos e resultados do tratamento de oito pacientes com angioma cavernoso intracraniano. Cinco apresentavam crise convulsiva; dois, manifestação de efeito de massa; um, hemorragia cerebral. A tomografia computadorizada de crânio e a ressonância magnética detectaram a lesão em todos os casos. Entretanto, não há uma imagem patognomômica para os angiomas cavernosos. Todos os pacientes foram submetidos a remoção microcirúrgica das suas lesões. Obtivemos remoção total da lesão em sete pacientes e subtotal em um. Não ocorreu óbito nesta série e somente um paciente apresentou novo deficit neurológico.

angioma cavernoso; mal formação vascular; crise convulsiva; hemorragia cerebral; microcirurgia

Clinical, radiological and histopathological features of eight cases of symptomatic cavernous angioma are presented. Five patients were being evaluated for seizure, two for mass lesions and one for intracranial hemorrhage. CT and/or MRI detected the lesion in all cases, but there is not a characteristic image for cavernous angioma. Good results were obtained by microsurgical approach to these malformations in seven patients with only one patient suffering a worsening of neurological status after surgery.

cavernous angioma; cerebral vascular malformation; seizure; cerebral hemorrhage; microsurgery

Angioma cavernoso intracraniano

Intracranial cavernous angioma

José Carlos Lynch^I; Ricardo Andrade^II; Celestino Pereira^III; J. Francisco Salomão^III; Francisco Duarte^IV; Francisca Gonçalves Carvalho^V; Edla Chadrycki^VI

^IDepartamentos de Neurocirurgia e de Anatomia Patológica do Hospital dos Servidores do Estado (HSE), Rio de Janeiro RJ: Chefe do Serviço de Neurocirurgia

^IIDepartamentos de Neurocirurgia e de Anatomia Patológica do Hospital dos Servidores do Estado (HSE), Rio de Janeiro RJ: Chefe de Clínica da Neurocirurgia

^IIIDepartamentos de Neurocirurgia e de Anatomia Patológica do Hospital dos Servidores do Estado (HSE), Rio de Janeiro RJ: Neurocirurgião

^IVDepartamentos de Neurocirurgia e de Anatomia Patológica do Hospital dos Servidores do Estado (HSE), Rio de Janeiro RJ: Chefe do Serviço de Anatomia Patológica

^VDepartamentos de Neurocirurgia e de Anatomia Patológica do Hospital dos Servidores do Estado (HSE), Rio de Janeiro RJ: Patologista

^VIDepartamentos de Neurocirurgia e de Anatomia Patológica do Hospital dos Servidores do Estado (HSE), Rio de Janeiro RJ: Neuro-Radiologista

RESUMO

Os autores apresentam dados clínicos, achados radiológicos, aspectos histopatológicos e resultados do tratamento de oito pacientes com angioma cavernoso intracraniano. Cinco apresentavam crise convulsiva; dois, manifestação de efeito de massa; um, hemorragia cerebral. A tomografia computadorizada de crânio e a ressonância magnética detectaram a lesão em todos os casos. Entretanto, não há uma imagem patognomômica para os angiomas cavernosos. Todos os pacientes foram submetidos a remoção microcirúrgica das suas lesões. Obtivemos remoção total da lesão em sete pacientes e subtotal em um. Não ocorreu óbito nesta série e somente um paciente apresentou novo deficit neurológico.

Palavras-chave: angioma cavernoso, mal formação vascular, crise convulsiva, hemorragia cerebral, microcirurgia.

SUMMARY

Clinical, radiological and histopathological features of eight cases of symptomatic cavernous angioma are presented. Five patients were being evaluated for seizure, two for mass lesions and one for intracranial hemorrhage. CT and/or MRI detected the lesion in all cases, but there is not a characteristic image for cavernous angioma. Good results were obtained by microsurgical approach to these malformations in seven patients with only one patient suffering a worsening of neurological status after surgery.

Key words: cavernous angioma, cerebral vascular malformation, seizure, cerebral hemorrhage, microsurgery.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 11-outubro-1993.

Dr. José Carlos Lynch - Rua Jardim Botânico 700/318 - 22461 -000 Rio de Janeiro RJ - Brasil.

1. Barlett JE, Kishore PRS. Intracranial cavernous angioma. Am J Roeentgenol 1977, 128:653-656.
2. Bicknell JM, Carlos TJ, Kornsfeld M, Stovring J, Turner P. Familial carvenous angiomas. Arch Neurol 1978, 35:746-749.
3. Chadduck WM, Binet EF, Farrell FW, Araoz CA, Reding DL. Intraventricular cavernous hemangioma: report of three cases and review of the literature. Neurosurgery 1985, 16:189-197.
4. Cohen HCM, Tucker WS, Humphreys RP, Perrin RJ. Angiographically cryptic histologically verified cerebrovascular malformations. Neurosurgery 1982, 10:704-714.
5. Fehlings MG, Tucker WS. Carvernous hemangioma of Meckel's cave: case report. J Neurosurg 1988, 68:645-647.
6. Ferreira NP, Ferreira MP. Optic nerve apoplexy caused by a cavernous angioma: case report. Neurosurgery 1992, 30:262-264.
7. Gangemi M, Longatti P, Maiuri f, Cinalli G, Carteri A. Cerebral cavernous angiomas in the first year of life. Neurosurg 1989, 25: 465-468.
8. Gomori JM, Grossman RI, Goldberg HJ, Hackney DB, Zimmerman RA, Bilamyk LT. Occult cerebral vascular malformations: hight-field MR imaging. Radiology 1986, 158:707-713.
9. Irazabal GM, Nenriquez MD. Hemangiomas cavernosos encefálicos. Arq Neuropsiquiatr 1984, 42:32-40.
10. Iwasa H, Indel I, Sato F. Intraventricular cavernous hemagioma. J Neurosurg 1983, 59: 153-157.
11. Kholsa VK, Banerjee AK, Mathuriya SN, Metha S. Giant cystic cavernoma in a child; case report. J Neurosurg 1984,60:1297-1299.
12. Lobato RD, Perez C, Rivas JJ, Cordobes F. Clinical radiological and pathological spectrum of angiographically occult intracranial vascular malformations: a analisys of 21 cases and review of the literature. J Neurosurg 1988, 68:518-531.
13. Martin NA, Wilson CB, Stein BM. Venous and cavernous malfomations in intracranial arterious malfarmations. In: Wilson CB, Stein BM (eds) Intracranial arteriovenous malformations. Baltimore: Williams and Wilkins 1984, p 234-245.
14. Mastromadi L, Ferrante, Scarpinari M, Gagliardi FM, Celli P, Fortuna A. Intradural extramedullar cavernous angioma: case report. Neurosurgery 1991, 29:924-926.
15. McCormick WF. The pathology of vascular (arteriovenous) malformations. J Neurosurg 1966,24:807-816.
16. McCormick WF, Hardman JM, Boulter TR. Vascular malformations ("angiomas") of the brain, with special reference in the posterior fossa. J Neurosurg 1968, 28:241-251.
17. Moritake K, Handa H, Nozaki K, Tomiwa K. Tentorial cavernous angioma with calcification in a neonate. Neurosurgery 1985, 16:207-211.
18. Ogilvy CS, Heros RC, Ofermann RG. Angiopraphically occult arteriovenous malformations. J Neurosurg 1988, 69:350-355.
19. Pozzati E, Giuliani G, Muzzo G, Poppi M. The growth of cerebral cavernous angiomas. Neurosurgery 1989, 25:92-96.
20. Pozzati E, Padovani R, Morrone B, Finizio F, Gaist G. Cerebral cavernous angiomas in children. J Neurosurg 1980, 53:826-832.
21. Rigamonti D, Hadley MN, Drayer BP, Johnson PC, Hoeng-Rigamonti K, Knight JT, Spetzler RE Cerebral cavernous malformations: incidence and familial occurrence. N Engl J Med 1988, 319:343-347.
22. Rigamonti D, Johnson PC, Spetzler RF, Hadley MN, Drayer BP. Cavernous malformations and capillary telangiectasia: a spectrum within a single pathological entity. Neurosurgery 1991, 28:60-64.
23. Rubinstein LJ. Tumors of the central nervous system. Washington: Armed Forces Institute of Pathology 1972, p 245-246.
24. Sarwar M, McCormick WF. Intracerebral venous angioma: case report and review. Arch Neurol 1978, 35:323-325.
25. Savoiardo M, Passerini A. CT, angiography and MR scan in intracranial carvenous hemagiomas. Neuroradiology 1978, 16:256-260.
26. Scott RM, Barnes P, Kupsky W, Adelman LS. Cavernous angiomas of the central nervous system in children. J Neurosurg 1992, 76:38-46.
27. Simard JM, Garcia-Bengoclea F, Ballinger WE, Mickle JP, Quisling RG. Cavernous angioma: a review of 126 collected and 12 new clinical cases. Neurosurgery 1986, 18: 162-172.
28. Steiger HJ, Markwalder TM, Revlem HJ. Clinicopathological relations of cerebral cavernous angiomas: observation in eleven cases. Neurosurgery 1987, 21:879,884.
29. Voigt K, Yasargil MG. Cerebral carvenous haemangiomas or cavernomas. Neurochirurgia 1976, 19:59-68.
30. Yamasaki T, Handa H, Yamashita J, Paine J, Tashiro Y, Uno A, Ishikawa M, Asato R. Intracranial and orbital cavernous angiomas J Neurosurg 1986, 64:197-208.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Jun 1994

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Barlett JE, Kishore PRS. Intracranial cavernous angioma. Am J Roeentgenol 1977, 128:653-656.

[2] 2. Bicknell JM, Carlos TJ, Kornsfeld M, Stovring J, Turner P. Familial carvenous angiomas. Arch Neurol 1978, 35:746-749.

[3] 3. Chadduck WM, Binet EF, Farrell FW, Araoz CA, Reding DL. Intraventricular cavernous hemangioma: report of three cases and review of the literature. Neurosurgery 1985, 16:189-197.

[4] 4. Cohen HCM, Tucker WS, Humphreys RP, Perrin RJ. Angiographically cryptic histologically verified cerebrovascular malformations. Neurosurgery 1982, 10:704-714.

[5] 5. Fehlings MG, Tucker WS. Carvernous hemangioma of Meckel's cave: case report. J Neurosurg 1988, 68:645-647.

[6] 6. Ferreira NP, Ferreira MP. Optic nerve apoplexy caused by a cavernous angioma: case report. Neurosurgery 1992, 30:262-264.

[7] 7. Gangemi M, Longatti P, Maiuri f, Cinalli G, Carteri A. Cerebral cavernous angiomas in the first year of life. Neurosurg 1989, 25: 465-468.

[8] 8. Gomori JM, Grossman RI, Goldberg HJ, Hackney DB, Zimmerman RA, Bilamyk LT. Occult cerebral vascular malformations: hight-field MR imaging. Radiology 1986, 158:707-713.

[9] 9. Irazabal GM, Nenriquez MD. Hemangiomas cavernosos encefálicos. Arq Neuropsiquiatr 1984, 42:32-40.

[10] 10. Iwasa H, Indel I, Sato F. Intraventricular cavernous hemagioma. J Neurosurg 1983, 59: 153-157.

[11] 11. Kholsa VK, Banerjee AK, Mathuriya SN, Metha S. Giant cystic cavernoma in a child; case report. J Neurosurg 1984,60:1297-1299.

[12] 12. Lobato RD, Perez C, Rivas JJ, Cordobes F. Clinical radiological and pathological spectrum of angiographically occult intracranial vascular malformations: a analisys of 21 cases and review of the literature. J Neurosurg 1988, 68:518-531.

[13] 13. Martin NA, Wilson CB, Stein BM. Venous and cavernous malfomations in intracranial arterious malfarmations. In: Wilson CB, Stein BM (eds) Intracranial arteriovenous malformations. Baltimore: Williams and Wilkins 1984, p 234-245.

[14] 14. Mastromadi L, Ferrante, Scarpinari M, Gagliardi FM, Celli P, Fortuna A. Intradural extramedullar cavernous angioma: case report. Neurosurgery 1991, 29:924-926.

[15] 15. McCormick WF. The pathology of vascular (arteriovenous) malformations. J Neurosurg 1966,24:807-816.

[16] 16. McCormick WF, Hardman JM, Boulter TR. Vascular malformations ("angiomas") of the brain, with special reference in the posterior fossa. J Neurosurg 1968, 28:241-251.

[17] 17. Moritake K, Handa H, Nozaki K, Tomiwa K. Tentorial cavernous angioma with calcification in a neonate. Neurosurgery 1985, 16:207-211.

[18] 18. Ogilvy CS, Heros RC, Ofermann RG. Angiopraphically occult arteriovenous malformations. J Neurosurg 1988, 69:350-355.

[19] 19. Pozzati E, Giuliani G, Muzzo G, Poppi M. The growth of cerebral cavernous angiomas. Neurosurgery 1989, 25:92-96.

[20] 20. Pozzati E, Padovani R, Morrone B, Finizio F, Gaist G. Cerebral cavernous angiomas in children. J Neurosurg 1980, 53:826-832.

[21] 21. Rigamonti D, Hadley MN, Drayer BP, Johnson PC, Hoeng-Rigamonti K, Knight JT, Spetzler RE Cerebral cavernous malformations: incidence and familial occurrence. N Engl J Med 1988, 319:343-347.

[22] 22. Rigamonti D, Johnson PC, Spetzler RF, Hadley MN, Drayer BP. Cavernous malformations and capillary telangiectasia: a spectrum within a single pathological entity. Neurosurgery 1991, 28:60-64.

[23] 23. Rubinstein LJ. Tumors of the central nervous system. Washington: Armed Forces Institute of Pathology 1972, p 245-246.

[24] 24. Sarwar M, McCormick WF. Intracerebral venous angioma: case report and review. Arch Neurol 1978, 35:323-325.

[25] 25. Savoiardo M, Passerini A. CT, angiography and MR scan in intracranial carvenous hemagiomas. Neuroradiology 1978, 16:256-260.

[26] 26. Scott RM, Barnes P, Kupsky W, Adelman LS. Cavernous angiomas of the central nervous system in children. J Neurosurg 1992, 76:38-46.

[27] 27. Simard JM, Garcia-Bengoclea F, Ballinger WE, Mickle JP, Quisling RG. Cavernous angioma: a review of 126 collected and 12 new clinical cases. Neurosurgery 1986, 18: 162-172.

[28] 28. Steiger HJ, Markwalder TM, Revlem HJ. Clinicopathological relations of cerebral cavernous angiomas: observation in eleven cases. Neurosurgery 1987, 21:879,884.

[29] 29. Voigt K, Yasargil MG. Cerebral carvenous haemangiomas or cavernomas. Neurochirurgia 1976, 19:59-68.

[30] 30. Yamasaki T, Handa H, Yamashita J, Paine J, Tashiro Y, Uno A, Ishikawa M, Asato R. Intracranial and orbital cavernous angiomas J Neurosurg 1986, 64:197-208.