Venous Angiomas with Arteriovenous Shunts: Report of Three Cases and Review of the Literature

Venous Angiomas with Arteriovenous Shunts: Report of Three Cases and Review of the Literature AbstractOBJECTIVE AND IMPORTANCE:In spite of recent recognition of the benign nature of venous angioma (VA), only limited information is available on the clinical features of VA with arteriovenous shunt (AVS). The purpose of this study was to elucidate the clinical profile of VA with AVS.CLINICAL PRESENTATION AND INTERVENTION:We describe three patients having a VA with AVS and review the clinical features of 31 patients reported in the literature, including our three patients. The patients included 12 women and 19 men, ranging in age from 18 to 54 years. Seven patients (22.6%) presented with intracranial hemorrhage, and none of 16 patients developed a new or recurrent hemorrhage (mean follow-up period, 11 months). Treatment was conservative in 14 patients, lobectomy or partial resection of the VA in 6, removal of hematoma in 4, operation only for coexisting aneurysm or arteriovenous malformation in 4, and not known in 3. The outcome was reported as good recovery in 19 patients, persistent neurological deficits in 2, death or deterioration not related to the VA in 3, and not known in 7.CONCLUSION:Although there remains some uncertainty as to the clinical features of VA with AVS, its prognosis seems to be essentially as benign as that of VA without AVS. Thus, conservative treatment is recommend except for patients with a large hematoma or with a coexisting arteriovenous malformation or a symptomatic, accessible cavernous angioma, which may be treated by surgical intervention. Further collection of data is required to establish definite treatment guidelines. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Venous Angiomas with Arteriovenous Shunts: Report of Three Cases and Review of the Literature

Venous Angiomas with Arteriovenous Shunts: Report of Three Cases and Review of the Literature

1328 Komiyama et al. arterial component (11), high-flow medul­ Venous Angiomas with Arteriovenous lary venous malformation (26), arterial- ized venous malformation (2), AVM with Shunts: Report of Three Cases and venous predominance (41, 42), transi­ tional form between a VA and an AVM Review of the Literature (22), or a mixed vascular malformation of a VA and an AVM (2, 8). Twenty-eight such cases have been reported in the literature. There is no M a s a k i K o m i y a m a , M . D . , K a z u h i r o Y a m a n a k a , M . D . , consensus on this entity as to whether it Y o s h i y a s u I w a i , M . D . , T o s h i h i r o Y a s u i , M . D . differs from a typical VA without AVS. Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan We report three additional cases having a VA w ith AVS and review the pertinent literature to clarify the clinical features of VA w ith AVS. O B JE C T IV E A N D IM P O R T A N C E : In spite of recent recognition of the benign nature of venous angioma (V A ), only lim ited inform ation is available on the clinical features of VA w ith arteriovenous shunt (A V S). The purpose of this study was to elucidate the clin ical profile of V A w ith A VS. C A SE P R E S E N T A T IO N C L IN IC A L P R E SE N T A T IO N A N D IN T E R V E N T IO N : W e describe three pa­ Patient 1 tients having a V A w ith A V S and review the clin ical features of 31 patients reported in the literature, including our three patients. The patients included A 26-year-old man underwent mag­ 12 women and 19 men, ranging in age from 18 to 54 years. Seven patients netic resonance imaging (MRI) to eval­ uate for numbness in both hands for (2 2 .6 % ) presented w ith intracranial hemorrhage, and none of 16 pa­ several years. The patient was neurolog­ tients developed a new or recurrent hemorrhage (mean follow-up period, ically normal, and his history was not 11 months). Treatm ent was conservative in 14 patients,...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199906000-00100
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE AND IMPORTANCE:In spite of recent recognition of the benign nature of venous angioma (VA), only limited information is available on the clinical features of VA with arteriovenous shunt (AVS). The purpose of this study was to elucidate the clinical profile of VA with AVS.CLINICAL PRESENTATION AND INTERVENTION:We describe three patients having a VA with AVS and review the clinical features of 31 patients reported in the literature, including our three patients. The patients included 12 women and 19 men, ranging in age from 18 to 54 years. Seven patients (22.6%) presented with intracranial hemorrhage, and none of 16 patients developed a new or recurrent hemorrhage (mean follow-up period, 11 months). Treatment was conservative in 14 patients, lobectomy or partial resection of the VA in 6, removal of hematoma in 4, operation only for coexisting aneurysm or arteriovenous malformation in 4, and not known in 3. The outcome was reported as good recovery in 19 patients, persistent neurological deficits in 2, death or deterioration not related to the VA in 3, and not known in 7.CONCLUSION:Although there remains some uncertainty as to the clinical features of VA with AVS, its prognosis seems to be essentially as benign as that of VA without AVS. Thus, conservative treatment is recommend except for patients with a large hematoma or with a coexisting arteriovenous malformation or a symptomatic, accessible cavernous angioma, which may be treated by surgical intervention. Further collection of data is required to establish definite treatment guidelines.

Journal

NeurosurgeryOxford University Press

Published: Jun 1, 1999

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