scholarly journals Paramedian Supracerebellar Infratentorial Approach for Pontine Cavernoma: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Nickalus R Khan ◽  
Jacques J Morcos
Keyword(s):  
Informed Consent ◽  
Clinical Course ◽  
Cavernous Malformation ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Postoperative Imaging ◽  
Brainstem Cavernoma ◽  
Supracerebellar Infratentorial Approach ◽  
The Right ◽  
Left Hemi

Abstract We describe the case of a 26-yr-old male who presented with headaches, dizziness, and left hemi-hypoesthesia in addition to being COVID-19 positive. The patient was found to have a large hemorrhage in the right dorsolateral pons that was found to be due to a pontine cavernous malformation. The patient underwent a right-sided paramedian supracerebellar infratentorial approach for resection of this lesion with preservation of the developmental venous anomaly. We present the operative video with a specific focus on approach selection, anatomic illustrations, and technical nuances. The literature on the timing of brainstem cavernoma surgery is reviewed.1-4 The patient's postoperative clinical course and postoperative imaging are reviewed. The patient gave informed consent for the procedure and verbal consent for being part of this submission and the publication of their image.

De Novo Cavernous Malformation Associated with a Pre-existing Developmental Venous Anomaly

2019 ◽  
Vol 30 (1) ◽  
pp. 181-184
Author(s):  
Daniel García-Pérez ◽  
Irene Panero ◽  
Alfonso Lagares ◽  
Pedro González
Keyword(s):  
De Novo ◽  
Cavernous Malformation ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly

Unique enlarging cavernous malformation secondary to abnormal arteriovenous shunting through an associated developmental venous anomaly

2021 ◽  
pp. 197140092110428
Author(s):  
Nimisha Parikh ◽  
Richard Williamson ◽  
Matthew Kulzer ◽  
Albert Sohn ◽  
Warren M Chang ◽  
...  
Keyword(s):  
Unusual Case ◽  
Cavernous Malformation ◽  
Vascular Malformations ◽  
Venous Hypertension ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Arteriovenous Shunting ◽  
Cavernous Malformations ◽  
Progressive Growth

Cavernous malformations are angiographically occult vascular malformations. They are often associated with a developmental venous anomaly through poorly understood mechanisms. We present an unusual case of a gradually enlarging cavernous malformation associated with a developmental venous anomaly with arteriovenous shunting, suggesting venous hypertension or reflux as a potential cause of progressive growth.

scholarly journals Morbidity After Symptomatic Hemorrhage of Cerebral Cavernous Malformation

Stroke ◽  
2020 ◽  
Vol 51 (10) ◽  
pp. 2997-3006
Author(s):  
Li Ma ◽  
Shuo Zhang ◽  
Zongze Li ◽  
Chun-Xue Wu ◽  
Zhaozhao Wang ◽  
...  
Keyword(s):  
Calibration Curve ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Cavernous Malformation ◽  
Cerebral Cavernous Malformation ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Discriminative Ability ◽  
Increased Risk

Background and Purpose: Symptomatic hemorrhage contributes to an increased risk of repeated bleeding and morbidity in cerebral cavernous malformation (CCM). A better understanding of morbidity after CCM hemorrhage would be helpful to identify patients of higher risk for unfavorable outcome and tailor individualized management. Methods: We identified 282 consecutive patients who referred to our institute from 2014 to 2018 for CCM with symptomatic hemorrhage and had an untreated follow-up period over 6 months after the first hemorrhage. The morbidity after hemorrhage was described in CCM of different features. Nomogram to predict morbidity was formulated based on the multivariable model of risk factors. The predictive accuracy and discriminative ability of nomogram were determined with concordance index (C-index) and calibration curve, and further validated in an independent CCM cohort of a prospective multicenter study from 2019 to 2020. Results: The overall morbidity of CCM was 26.2% after a mean follow-up of 1.9 years (range 0.5–3.5 years) since the first hemorrhage. The morbidity during untreated follow-up was associated with hemorrhage ictus (adjusted odds ratio per ictus increase, 4.17 [95% CI, 1.86–9.33]), modified Rankin Scale score at initial hemorrhage (adjusted odds ratio per point increase, 2.57 [95% CI, 1.82–3.63]), brainstem location (adjusted odds ratio, 2.93 [95% CI, 1.28–6.68]), and associated developmental venous anomaly (adjusted odds ratio, 2.21 [95% CI, 1.01–4.83]). Subgroup analysis revealed similar findings in brainstem and non-brainstem CCM. Nomogram was contracted based on these features. The calibration curve showed good agreement between nomogram prediction and actual observation. The C-index of nomogram predicting morbidity was 0.83 (95% CI, 0.77–0.88). In validation cohort, the nomogram maintained the discriminative ability (C-index, 0.87 [95% CI, 0.78–0.96]). Conclusions: Multiple symptomatic hemorrhages, initial neurological function after hemorrhage, brainstem location, and associated developmental venous anomaly were associated with morbidity of CCM hemorrhage. The nomogram represented a practical approach to provide individualized risk assessment for CCM patients. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT04076449.

The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation?

2010 ◽  
Vol 52 (10) ◽  
pp. 883-891 ◽  
Author(s):  
Yoo Jin Hong ◽  
Tae-Sub Chung ◽  
Sang Hyun Suh ◽  
Chul Hwan Park ◽  
Geetanjali Tomar ◽  
...  
Keyword(s):  
Cavernous Malformation ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly

The Juxtaposition of a Capillary Telangiectasia, Cavernous Malformation, and Developmental Venous Anomaly in the Brainstem of a Single Patient: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 49 (5) ◽  
pp. 1246-1250 ◽  
Author(s):  
Richard E. Clatterbuck ◽  
İlhan Elmacı ◽  
Daniele Rigamonti
Keyword(s):  
Cavernous Malformation ◽  
Vascular Malformations ◽  
Magnetic Resonance Imaging Examination ◽  
Developmental Venous Anomaly ◽  
Venous Malformations ◽  
Venous Anomaly ◽  
Single Patient ◽  
Cavernous Malformations ◽  
Swallowing Problems ◽  
Capillary Telangiectasia

ABSTRACT OBJECTIVE AND IMPORTANCE Capillary telangiectasias, cavernous malformations, and developmental venous anomalies are all vascular malformations that occur on the capillary-venous side of the cerebral circulation. The associations of capillary telangiectasias with venous malformations, cavernous malformations with venous malformations, and capillary telangiectasias with cavernous malformations have all been described; however, the association of all three lesions in a single patient is extremely rare. CLINICAL PRESENTATION A 52 year-old Caucasian woman presented to our clinic with an extended history of confusion, distorted visual perceptions, photophobia, neck pain, swallowing problems, and poor balance. The patient's examination was remarkable for difficulty concentrating, mild rotatory nystagmus, subtle decreased sensation over the left side of the face and body, and brisk reflexes. Review of the patient's magnetic resonance imaging examination demonstrated a cavernous malformation, a capillary telangiectasia, and a developmental venous anomaly located adjacent to one another in the brainstem. INTERVENTION Given the patient's complex constellation of symptoms and relatively mild neurological findings, it was difficult to ascribe any one of them to a specific vascular malformation. Conservative management of this patient's vascular malformations was decided upon. CONCLUSION Juxtaposition of these three different vascular lesions in the brainstem of an otherwise normal individual suggests a relationship among them. Although there are several theories that link similar associations through physiological mechanisms such as venous hypertension, we propose that a developmental event disrupting local capillary-venous pattern formation is a plausible alternative.

THROMBOSED BRAINSTEM DEVELOPMENTAL VENOUS ANOMALY CAUSING HYDROCEPHALUS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.99-e4
Author(s):  
Katherine Dodd ◽  
Emily Pegg ◽  
Sachin Mathur ◽  
Chhetri Suresh
Keyword(s):  
Posterior Fossa ◽  
Drainage System ◽  
Venous Drainage ◽  
Cerebellar Hemisphere ◽  
Cerebral Peduncle ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Venous Infarction ◽  
Heparin Infusion ◽  
The Right

Developmental venous anomaly (DVA) is a commonly encountered congenital abnormality of the venous drainage system. Spontaneous thrombosis of DVA is rare. We present a case of thrombosed brainstem DVA leading to venous infarction and oedema within the posterior fossa.A 49 year old, previously fit gentleman presented to the local hospital with a one day history of headache, slurred speech and incoordination. Examination demonstrated GCS of 13/15, cerebellar dysarthria, horizontal nystagmus to the left, mild right sided pyramidal weakness, right sided cerebellar ataxia and bilateral extensor plantars.CT venogram revealed a cerebellar DVA with thrombosis of one of the veins. There was surrounding venous infarction and oedema within the posterior fossa, causing compression of the fourth ventricle and dilatation of the lateral ventricles. MRI demonstrated extensive T2 change in the right cerebellar hemisphere, dorsal pons and right cerebral peduncle. No underlying thrombotic tendency was identified. He was treated successfully with intravenous heparin infusion. He improved over the next 3 weeks, and was discharged on warfarin with mild right sided ataxia and cerebellar dysarthria.Our case demonstrates that DVAs, generally considered as common insignificant anatomical variants, can uncommonly lead to significant complications.

scholarly journals Microscopic trans-cerebellar approach for infratentorial cavernous malformation near the lateral recess associated with developmental venous anomaly

2019 ◽  
pp. 513-516
Author(s):  
Samer S. Hoz ◽  
Awfa A. Aktham ◽  
Hassan M. Bdaiwi ◽  
Alyaa A. Khadim ◽  
Zainab A. Jihan ◽  
...  
Keyword(s):  
Emergency Department ◽  
Surgical Approach ◽  
Cavernous Malformation ◽  
Target Lesion ◽  
Developmental Venous Anomaly ◽  
Venous Anomaly ◽  
Case Scenario ◽  
Lateral Recess ◽  
Intimate Association ◽  
Selection Of

Background: Reports showed the intimate association of the developmental venous anomaly with infra-tentorial cavernous malformation. This association has several clinical and surgical implications, sometimes this association will be a surgical challenge and affect the selection of the safest approach to the lesion. Surgery for infratentorial cavernoma is indicated for accessible symptomatic lesion only. Case scenario: we present a case of deep cerebello-pontine CM adjacent to the lateral recess, presented with acute clinical deterioration to the emergency department of the Neurosurgery Teaching Hospital in Baghdad, Iraq, with the only possible approach was Trans-cerebellar approach because of the medial location of the associated DVA. Conclusion: The association of developmental venous anomaly with infratentorial cavernous malformation has a pivotal role in selection the most appropriate and safe surgical approach which should be based upon the individualized patient anatomy and the location of the target lesion.

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