Neurological Surgery No Shinkei Geka Volume 45, Issue 4 (April 2017)

De Novo Cavernous Angioma Secondary to a Developmental Venous Anomaly:A Case Report and Review of the Literature Yohtaro SAKAKIBARA 1 , Yoshio TAGUCHI 1 , Homare NAKAMURA 1 , Hidetaka ONODERA 1 , Masashi UCHIDA 1 , Kimiyuki KAWAGUCHI 1 , Yoshio AIDA 2 1Division of Neurosurgery, St Marianna University School of Medicine, Yokohama City Seibu Hospital 2Department of Pathology, St Marianna University School of Medicine, Yokohama City Seibu Hospital Keyword: cavernous angioma , developmental venous anomaly , de novo , transcallosal transventricular approach , hypersomnia pp.325-331
Published Date 2017/4/10
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 OBJECTIVE:Previously, cavernous angiomas(CAs)have been thought to be only congenital in origin. Recently, however, a few cases of de novo CAs have been reported in the literature. We present a case of a de novo CA and discuss the etiology of the newly appeared CA.

 CASE REPORT:A 29-year-old man was presented to a local clinic because of hypersomnia. MRI demonstrated a heterogeneous mass peripherally located, which was in contact with a developmental venous anomaly(DVA)at the left thalamus. Six years before the presentation, he visited the same clinic because of faintness, and MRI results indicated no abnormality except for the DVA. Three weeks later, he suddenly experienced difficulty in speech, and the MRI revealed an increase in the size of the mass. Subsequently, he was admitted at our institution, and neurological examination revealed aphasia and right hemiparesis. A left carotid angiogram on venous phase showed a narrowing of the DVA, which was seen as it entered the internal cerebral vein. The diagnosis of a de novo CA was made. The mass was completely resected through the transcallosal transventricular approach to avoid injuring the DVA. The DVA could not be found during surgery. The pathological diagnosis was in line with the findings of CA. Postoperatively, the patient continued having difficulty in speech and was transferred to another institution for speech rehabilitation.

 CONCLUSIONS:Although the association of CA and DVA has been described with increasing frequencies recently, the etiology of de novo CA in the case of this association has been a matter of debate. In the present case, it was speculated that a narrowing of the DVA resulted in increased venous pressure and caused the development of de novo CA.

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Neurological Surgery 脳神経外科
45巻4号 (2017年4月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院