Ruptured pontine cavernomas in infants: a report of two cases
- PDF / 4,549,267 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 75 Downloads / 231 Views
CASE REPORT
Ruptured pontine cavernomas in infants: a report of two cases Ioan Alexandru Florian 1,2 & Teodora Larisa Timis 3 & Kinga Renata Kiss 1 & Ioan Stefan Florian 1,2 & Ioana Berindan-Neagoe 4,5 Received: 3 July 2020 / Accepted: 22 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Cavernous malformations (CMs) are either congenital or acquired vascular lesions comprised of sinusoid spaces filled with either blood or its breakdown products. They possess a relatively reduced risk of hemorrhage, yet placement within the posterior fossa and especially the brainstem heightens their likelihood to rupture, making them a likely cause of permanent and debilitating neurological deficit, as well as a veritable surgical challenge. Although the incidence of rupture varies with age among reported case series, it is undoubtable that the severity of this occurrence is the highest while the brain is as its most vulnerable period, i.e. during infancy. Case presentations We present two patients, both female, 6.5- and 5-months-old respectively, who presented with brainstem hemorrhage from CM. They suffered from a sudden onset of hemiparesis and were subjected to surgical removal of their lesions and resulting hematomas. Both patients were discharged in a favorable neurological status and are currently alive and in good health. Conclusion Microsurgical treatment of brainstem CMs in infants is not only possible with minimal deficit, but also advisable if the lesions are symptomatic. Nevertheless, this requires substantial patience and experience to prevent significant loss of blood and injury to the structures of the posterior fossa. We argue that the safest method to prevent further damage from brainstem CM rebleed is to remove these lesions shortly after the initial hemorrhage. Keywords Cavernous malformation (CM) . Infant . Hemorrhagic stroke . Surgical removal . Brainstem
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00381-020-04898-8) contains supplementary material, which is available to authorized users. * Ioan Alexandru Florian [email protected] 1
Clinic of Neurosurgery, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania
2
Department of Neurosurgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
3
Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
4
The Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
5
Functional Genomics and Experimental Pathology Department, The Oncology Institute “Prof. Dr. Ion Chiricuta”, Cluj-Napoca, Romania
Intracranial cavernous malformations (CMs), otherwise known as cavernomas, represent congenital or occasionally acquired anomalies of the cerebral vasculature, being the second most common intracranial vascular malformation [1–4]. They are typically asymptomatic and disco
Data Loading...
