Resection of a cerebellar cavernoma: A case report
Article Sidebar
Main Article Content
Abstract
Introduction: cavernomatous malformations are cerebral hamartomas that represent 20% of cerebral vascular malformations, the clinical manifestations are linked to the location of the lesion, these being seizures, headache, focal neurological deficit, in its diagnosis it is done by resonance magnetic in T2 sequence with two characteristic signs, the popcorn sign and the hypointense haemosiderin ring, maintain a complex treatment, this being conservative, surgical resection, stereotactic radiosurgery. Methodology: Scientific information was acquired from the PubMed search engine of high-impact articles on the topic of interest in English with translation into Spanish in the years 2017 to 2020. Clinical case: A 17-year-old female patient, with a significant history of petit mal seizures for 6 years and a father with a diagnosis of cavernous angioma, currently the patient presents intermittent holocranial headache, throbbing type accompanied by tonic-clonic seizures of approximately 10 minutes duration. 3 occasions per week. MR-type imaging studies were performed, showing lesions of heterogeneous intensity on the T2 sequence with a hypointense ring in the vermis and right cerebellar hemisphere. Conclusion: Cavernomas establish a neurological pathology that encompasses a limitation in the quality of life of patients on the pharmacological treatment of seizures, the appropriate choice of the type of therapy lies in the clinical manifestations and the anatomical occupation of the vascular lesion, improving thus, comorbidities, clinical parameters, and response to pharmacological treatment.
Downloads
Article Details
References
Agosti, E., Flemming, K. D. & Lanzino, G. (2019). Symptomatic Cavernous Malformation Presenting with Seizure without Hemorrhage: Analysis of Factors Influencing Clinical Presentation. World Neurosurgery, 129, e387–e392. https://doi.org/10.1016/j.wneu.2019.05.157
Algattas, H., Abou-Al-Shaar, H., Mendelson, M., Arnold, G. L., Felker, J., Meade, J. & Greene, S. (2020). Familial Cerebral Cavernous Malformation Syndrome with Concomitant Fourth Ventricular Ependymoma: True Association or Mere Coincidence? Cancer Genetics, 244, 36–39. https://doi.org/10.1016/j.cancergen.2020.04.075
Awad, I. & Jabbour, P. (2006). Cerebral cavernous malformations and epilepsy. Neurosurgical Focus, 21(1), 1–9. https://doi.org/10.3171/foc.2006.21.1.8
Fehrenbach, M. K., Kuzman, P., Quaeschling, U., Meixensberger, J. & Nestler, U. (2019). Endoscopic resection of an intraventricular cavernoma: A case report. International Medical Case Reports Journal, 12, 249–252. https://doi.org/10.2147/IMCRJ.S214917
Flemming, K. D., Kumar, S., Brown, R. D. & Lanzino, G. (2020). Predictors of Initial Presentation with Hemorrhage in Patients with Cavernous Malformations. World Neurosurgery, 133, e767–e773. https://doi.org/10.1016/j.wneu.2019.09.161
Flemming, K. D. & Lanzino, G. (2020). Cerebral Cavernous Malformation: What a Practicing Clinician Should Know. Mayo Clinic Proceedings, 95(9), 2005–2020. https://doi.org/10.1016/j.mayocp.2019.11.005
Hong, C. C., Tang, A. T., Detter, M. R., Choi, J. P., Wang, R., Yang, X., Guerrero, A. A., Wittig, C. F., Hobson, N., Girard, R., Lightle, R., Moore, T., Shenkar, R., Polster, S. P., Goddard, L. M., Ren, A. A., Leu, N. A., Sterling, S., Yang, J., … Kahn, M. L. (2020). Cerebral cavernous malformations are driven by ADAMTS5 proteolysis of versican. Journal of Experimental Medicine, 217(10). https://doi.org/10.1084/JEM.20200140
Ishii, K., Tozaka, N., Tsutsumi, S., Muroi, A. & Tamaoka, A. (2020). Familial cerebral cavernous malformation presenting with epilepsy caused by mutation in the CCM2 gene. Medicine, 29(March).
Joseph, N. K., Kumar, S., Lanzino, G. & Flemming, K. D. (2020). The Influence of Physical Activity on Cavernous Malformation Hemorrhage. Journal of Stroke and Cerebrovascular Diseases, 29(4), 104629. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104629
Khallaf, M. & Abdelrahman, M. (2019). Supratentorial cavernoma and epilepsy: Experience with 23 cases and literature review. Surgical Neurology International, 10(117), 117. https://doi.org/10.25259/sni-178-2019
Mondejar, R. & Lucas, M. (2017). Diagnóstico molecular de cavernomatosis cerebral. Neurologia, 32(8), 540–545. https://doi.org/10.1016/j.nrl.2015.07.001
Padarti, A. & Zhang, J. (2018). Recent advances in cerebral cavernous malformation research. Vessel Plus, 2(8), 21. https://doi.org/10.20517/2574-1209.2018.34
Palkopoulou, M., Bakola, E., Foliadi, M., Stefanidis, P. & Acquaviva, P. T. (2020). Cerebral Cavernous Malformation in a Patient with Pontine Hemorrhage: A Case Study. Clinics and Practice, 10(3), 74–77. https://doi.org/10.4081/cp.2020.1211
Steven M. Singer#, Marc Y. Fink, V. V. A. (2019). Cavernous angiomas: deconstructing a neurosurgical disease. J Neurosurg., 131(1). https://doi.org/10.3171/2019.3.JNS181724.Cavernous
Willie, J. T., Malcolm, J. G., Stern, M. A., Lowder, L. O., Neill, S. G., Cabaniss, B. T. & Drane, D. L. (2019). Epileptogenic Cerebral Cavernous Malformations. Epilepsia, 60(2), 220–232. https://doi.org/10.1111/epi.14634.Safety
Yang, P. F., Pei, J. S., Jia, Y. Z., Lin, Q., Xiao, H., Zhang, T. T. & Zhong, Z. H. (2018). Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations. World Neurosurgery, 110, e659–e670. https://doi.org/10.1016/j.wneu.2017.11.067
Zhang, S., Ma, L., Wu, C., Wu, J., Cao, Y., Wang, S. & Zhao, J. (2020). A rupture risk analysis of cerebral cavernous malformation associated with developmental venous anomaly using susceptibility-weighted imaging. Neuroradiology, 62(1), 39–47. https://doi.org/10.1007/s00234-019-02274-1