Hemangiomas cavernosos encefalicos: presentacion de dos casos

Manuel Irazabal, G.; Marco Henriquez, D.

doi:10.1590/S0004-282X1984000100006

Resúmenes

Dos casos de hemangiomas cavernosos encefálicos intervenidos quirúrgicamente con resultados satisfactorios son relatados. Consideramos necesario la práctica de estudios angiográficos, gammagráficos y sobre todo la tomografía axial computada con el objeto de aproximarse a un diagnóstico cierto. El tratamiento de elección es quirúrgico, siendo el pronóstico reservado en caso de no ser posible la intervención; así recalcamos la necesidad de efectuar un diagnóstico precoz y determinar las posibilidades quirúrgicas, a fin de beneficiar al máximo los pacientes.

Two cases of encephalic cavernous hemangiomas successfully surgically treated are described. Neurological clinical picture is not characteristic and it is given by the size, number and location of lesions in addition to the possibility of bleeding. Precise diagnostic done by angiography, gammagraphy and CT scan is of utmost importance to consider surgical approach. Surgery is the best means to treat the lesion although if surgery is contraindicated prognosis is poor due to episodes of hemorrhage that can accompany this pathology.

Hemangiomas cavernosos encefalicos. Presentacion de dos casos

Encephalic cavernous hemangiomas: report of two cases

Manuel Irazabal G.; Marco Henriquez D.

Médico Auxiliar. Servicio de Neurologia y Neurocirurgía, Hospital Militar «Dr. Carlos Arvelo», Caracas (Venezuela)

RESUMEN

Dos casos de hemangiomas cavernosos encefálicos intervenidos quirúrgicamente con resultados satisfactorios son relatados. Consideramos necesario la práctica de estudios angiográficos, gammagráficos y sobre todo la tomografía axial computada con el objeto de aproximarse a un diagnóstico cierto. El tratamiento de elección es quirúrgico, siendo el pronóstico reservado en caso de no ser posible la intervención; así recalcamos la necesidad de efectuar un diagnóstico precoz y determinar las posibilidades quirúrgicas, a fin de beneficiar al máximo los pacientes.

SUMMARY

Two cases of encephalic cavernous hemangiomas successfully surgically treated are described. Neurological clinical picture is not characteristic and it is given by the size, number and location of lesions in addition to the possibility of bleeding. Precise diagnostic done by angiography, gammagraphy and CT scan is of utmost importance to consider surgical approach. Surgery is the best means to treat the lesion although if surgery is contraindicated prognosis is poor due to episodes of hemorrhage that can accompany this pathology.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Trabajo realizado en el Servicio de Neurologia y Neurocirurgía, Hospital Militar «Dr. Carlos Arvelo», Caracas (Venezuela).

An. San Bosco. Qta. Ira-Gon, 2.01 - 57.18. Altamira - Caracas, Venezuela.

1. AOKI, H.; OGASHIWA, M.; WAKUTUNI, K. & ITO E. - Cavernous hemangiomas of the cerebral hemisphere: a case report. Brain Nerv. 23:927, 1971.
2. BOGREN, H.; SUALANDER, C. & WICKBOM, I. - Angiography in intracranial cavernous hemangiomas. Acta radiol. 10:81, 1970.
3. CLARK, J. V. - Familial occurence of cavernous angiomata of the brain, J. Neurol. Neurosurg. Psychiat. 33:871, 1970.
4. DIAMONT, C; TORVIK, A. & AMUNDSEN, P. - Angiographic diagnosis of telangiectases with cavernous angioma of the posterior fossa. Acta radiol. 17: 281, 1976.
5. ESCOUROLLE, R. & POIRIER, J. - Manual of Basic Neuropathology. Ed. 2. W. B. Saunders Co. Philadelphia, 1978, pg. 79.
6. GARCIN, R.; CASTAIGNE, P.; RONDOT, P.; ESCOUROLLE, R. & R1BADEAN DUMAS, J. L. - Syndrome de la comissure de Wernekink por malformation vasculaire. Dégénerescences olivaires et cérébelleuses associées. Rev. neurol. (Paris) 124:417, 1971.
7. GESCHICKTER, C. F. - Bone Tumors. Amer. J. Roentgenol. 34:1, 1935.
8. IRGENS, C. E. - Hemangioma of skull involving right petrous and occipital bones. Arch. Otolaryng. 29:709, 1939.
9. JAIN, K. K. & ROBERTSON, E. - Recurrence of an exiced cavernous hemangioma in the oposite cerebral hemisphere. Case report. J. Neurosurg. 33:453, 1970.
10. JONITUS, A. J.; SONDHEIMER, F. K.; KLEIN, H. Z. & WISE, B. L. - Intracerebral cavernous hemangioma with angiographically demonstrated pathologic vasculature. Neurorradiol. 3:57, 1971.
11. KESSLER, L. A.; LUBIC, L. G. & KOSFOFF, Y. D. - Epidural hemorrhage secondary to cavernous hemangioma of the patrous portion of the temporal bone. J. Neurosurg. 14:329, 1957.
12. KIRCHHOFF, D.; AGNOL, A. L. & EGGERT, H. - Hemangiomas cavernosos do crânio. Arq. Neuro-Psiquiat. (S. Paulo) 35:307, 1977.
13. KRAUYENBUHL, H. & SIEBENMANN, R. - Vascular malformation as a cause of primary intracerebral hemorrhage. J. Neurosurg. 22:7, 1965.
14. KROLL, F. W. & STEAMMLER, M. - Sturge - Weber Erkrankung. Arch. Psychiat. Nervenkr. 181:168, 1948.
15. KUFS, H. - Uber Heredofamilial Angiomatose des Gehirns und der Retina, ihre bezichungen Zueinander und zur Angiomatose der Haut. Z. Neurol. Psychiat. 113:651, 1928.
16. MANUELIDIS, E. E. - Uber Hemangiome des Gehrins. Arch. Psychiat. Nervenkr. 184:601, 1950.
17. Mc CORMICK, W. F. - The pathology of vascular (arteriovenous) malformations. J. Neurosurg. 24:897, 1966.
18. MICHAEL, J. C. & LEVIN, P. M. - Multiple telangiectases of the brain. A discussion of hereditary factors in their development. Arch. Neurol. Psychiat. 36: 314, 1936.
19. PASZTOR, E.; SZABO, G.; SLOWIK, F. & ZOLTAN, G. - Cavernous hemangioma of the base of the skull. J. Neurosurg. 21:582, 1964.
20. PETERS, G. - Zur Pathogenese der Sturge Weberschen Krankheit. Z. Neur. 164:365, 1964.
21. PLUM, F. & POSNER, H. B. - The Diagnosis of Stupor and Coma. Ed. 2. Contemporary Neurology Series, vol. 10:20. F. A. Davis Co. Philadelphia, 1972.
22. PRENSKY, A. L. & GADO, M. - Agiographic resolution of a neonatal intracranial cavernous hemangioma coincident with steroid therapy. J. Neurosurg. 30:99, 1973.
23. ROBERSON, E. H.; KASE, C. S. & WOLPOW, E. R. - Telengiectases and cavernous angiomas of the brain stem: cryptic vascular malformations. Neurora-diol. 8:53, 1974.
24. RUNNELS, J. B.; GIFFORD, D. B.; FORSBERG, P. L. & HANBERY, J. W. - Dense calcification and a large cavernous angioma. J. Neurosurg. 30:293, 1969.
25. RUSSELL, D. - Discussion on vascular tumours of the brain and spinal cord. Proc. roy. Soc. Med. 24:383, 1931.
26. RUSSELL, D. & RUBINSTEIN, L. J. - Pathology of Tumours of the Nervous System. Ed. 3. Ed. Arnold. London, 1971, pg. 72.
27. SCHNEIDER, R. C. & LISS, L. - Cavernous hemangiomas of the cerebral hemispheres. J. Neurosurg. 13:392, 1958.
28. SCHOTT, B. - Cavernoma of the ponto-cerebellar angle. J. franc. Oto-rhinolaryng. 19:339, 1970.
29. SEGALL, H. D.; SEGAL, H. L.; TEAL, J. S.; RUMBAUGH, C. L. & BERGERON, R. T. - Calcifying cerebral cavernous hemangioma with brain scan and angiographic findings. Neuroradiol. 7:133, 1974.
30. SJOVALL, E. & LUNDGREN, N. - Zur Kentnis des Angioma simplex cerebri. Acta path, microbiol. scand. 37:476, 1938.
31. VOIGT, K. & YASARGIL, M. G. - Cerebral cavernous hemangiomas or caver-nomas. Neurochirurgia 19:59, 1976.
32. WOOD, M. W.; WHITE, R. J. & KERNOHAN, J. W. - Cavernous hemangiomatosis involving the brain, spinal cord, heart, skin and kidney. Proc. Mayo Clinic. 32:249, 1957.
33. WYKE, B. D. - Primary hemangioma of the skull: a rare cranial tumour. Radiol. 61:302, 1949.

Fechas de Publicación

Publicación en esta colección
14 Ago 2012
Fecha del número
Mar 1984

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AOKI, H.; OGASHIWA, M.; WAKUTUNI, K. & ITO E. - Cavernous hemangiomas of the cerebral hemisphere: a case report. Brain Nerv. 23:927, 1971.

[2] 2. BOGREN, H.; SUALANDER, C. & WICKBOM, I. - Angiography in intracranial cavernous hemangiomas. Acta radiol. 10:81, 1970.

[3] 3. CLARK, J. V. - Familial occurence of cavernous angiomata of the brain, J. Neurol. Neurosurg. Psychiat. 33:871, 1970.

[4] 4. DIAMONT, C; TORVIK, A. & AMUNDSEN, P. - Angiographic diagnosis of telangiectases with cavernous angioma of the posterior fossa. Acta radiol. 17: 281, 1976.

[5] 5. ESCOUROLLE, R. & POIRIER, J. - Manual of Basic Neuropathology. Ed. 2. W. B. Saunders Co. Philadelphia, 1978, pg. 79.

[6] 6. GARCIN, R.; CASTAIGNE, P.; RONDOT, P.; ESCOUROLLE, R. & R1BADEAN DUMAS, J. L. - Syndrome de la comissure de Wernekink por malformation vasculaire. Dégénerescences olivaires et cérébelleuses associées. Rev. neurol. (Paris) 124:417, 1971.

[7] 7. GESCHICKTER, C. F. - Bone Tumors. Amer. J. Roentgenol. 34:1, 1935.

[8] 8. IRGENS, C. E. - Hemangioma of skull involving right petrous and occipital bones. Arch. Otolaryng. 29:709, 1939.

[9] 9. JAIN, K. K. & ROBERTSON, E. - Recurrence of an exiced cavernous hemangioma in the oposite cerebral hemisphere. Case report. J. Neurosurg. 33:453, 1970.

[10] 10. JONITUS, A. J.; SONDHEIMER, F. K.; KLEIN, H. Z. & WISE, B. L. - Intracerebral cavernous hemangioma with angiographically demonstrated pathologic vasculature. Neurorradiol. 3:57, 1971.

[11] 11. KESSLER, L. A.; LUBIC, L. G. & KOSFOFF, Y. D. - Epidural hemorrhage secondary to cavernous hemangioma of the patrous portion of the temporal bone. J. Neurosurg. 14:329, 1957.

[12] 12. KIRCHHOFF, D.; AGNOL, A. L. & EGGERT, H. - Hemangiomas cavernosos do crânio. Arq. Neuro-Psiquiat. (S. Paulo) 35:307, 1977.

[13] 13. KRAUYENBUHL, H. & SIEBENMANN, R. - Vascular malformation as a cause of primary intracerebral hemorrhage. J. Neurosurg. 22:7, 1965.

[14] 14. KROLL, F. W. & STEAMMLER, M. - Sturge - Weber Erkrankung. Arch. Psychiat. Nervenkr. 181:168, 1948.

[15] 15. KUFS, H. - Uber Heredofamilial Angiomatose des Gehirns und der Retina, ihre bezichungen Zueinander und zur Angiomatose der Haut. Z. Neurol. Psychiat. 113:651, 1928.

[16] 16. MANUELIDIS, E. E. - Uber Hemangiome des Gehrins. Arch. Psychiat. Nervenkr. 184:601, 1950.

[17] 17. Mc CORMICK, W. F. - The pathology of vascular (arteriovenous) malformations. J. Neurosurg. 24:897, 1966.

[18] 18. MICHAEL, J. C. & LEVIN, P. M. - Multiple telangiectases of the brain. A discussion of hereditary factors in their development. Arch. Neurol. Psychiat. 36: 314, 1936.

[19] 19. PASZTOR, E.; SZABO, G.; SLOWIK, F. & ZOLTAN, G. - Cavernous hemangioma of the base of the skull. J. Neurosurg. 21:582, 1964.

[20] 20. PETERS, G. - Zur Pathogenese der Sturge Weberschen Krankheit. Z. Neur. 164:365, 1964.

[21] 21. PLUM, F. & POSNER, H. B. - The Diagnosis of Stupor and Coma. Ed. 2. Contemporary Neurology Series, vol. 10:20. F. A. Davis Co. Philadelphia, 1972.

[22] 22. PRENSKY, A. L. & GADO, M. - Agiographic resolution of a neonatal intracranial cavernous hemangioma coincident with steroid therapy. J. Neurosurg. 30:99, 1973.

[23] 23. ROBERSON, E. H.; KASE, C. S. & WOLPOW, E. R. - Telengiectases and cavernous angiomas of the brain stem: cryptic vascular malformations. Neurora-diol. 8:53, 1974.

[24] 24. RUNNELS, J. B.; GIFFORD, D. B.; FORSBERG, P. L. & HANBERY, J. W. - Dense calcification and a large cavernous angioma. J. Neurosurg. 30:293, 1969.

[25] 25. RUSSELL, D. - Discussion on vascular tumours of the brain and spinal cord. Proc. roy. Soc. Med. 24:383, 1931.

[26] 26. RUSSELL, D. & RUBINSTEIN, L. J. - Pathology of Tumours of the Nervous System. Ed. 3. Ed. Arnold. London, 1971, pg. 72.

[27] 27. SCHNEIDER, R. C. & LISS, L. - Cavernous hemangiomas of the cerebral hemispheres. J. Neurosurg. 13:392, 1958.

[28] 28. SCHOTT, B. - Cavernoma of the ponto-cerebellar angle. J. franc. Oto-rhinolaryng. 19:339, 1970.

[29] 29. SEGALL, H. D.; SEGAL, H. L.; TEAL, J. S.; RUMBAUGH, C. L. & BERGERON, R. T. - Calcifying cerebral cavernous hemangioma with brain scan and angiographic findings. Neuroradiol. 7:133, 1974.

[30] 30. SJOVALL, E. & LUNDGREN, N. - Zur Kentnis des Angioma simplex cerebri. Acta path, microbiol. scand. 37:476, 1938.

[31] 31. VOIGT, K. & YASARGIL, M. G. - Cerebral cavernous hemangiomas or caver-nomas. Neurochirurgia 19:59, 1976.

[32] 32. WOOD, M. W.; WHITE, R. J. & KERNOHAN, J. W. - Cavernous hemangiomatosis involving the brain, spinal cord, heart, skin and kidney. Proc. Mayo Clinic. 32:249, 1957.

[33] 33. WYKE, B. D. - Primary hemangioma of the skull: a rare cranial tumour. Radiol. 61:302, 1949.

Brasil

Brasil

Hemangiomas cavernosos encefalicos: presentacion de dos casos

Encephalic cavernous hemangiomas: report of two cases

Resúmenes

Fechas de Publicación