Lechevalier B, Houtteville J P
Service de Neurologie Dejerine, CHU de Caen, UFR de Médecine et INSERM U 320, Université de Caen.
Rev Neurol (Paris). 1992;148(3):173-9.
Cavernous angiomas are vascular malformations that belong to the group of hamartomas. Evidence to support the hypothesis that some intracranial cavernous angiomas are benign vascular tumors is lacking. As they are angiographically occult, cavernous angiomas were largely overlooked and were considered rare before CT scan and MRI became available. Both of these techniques provide a quick and accurate diagnosis in cases of epilepsy, brain hemorrhage or intracranial hypertension. Most of the hemispheric cavernous angiomas are situated subcortically, in the neighborhood of the rolandic fissure. In the brain stem, they can be found mostly in the pons. Cerebellum and spinal cord are seldom involved. Cavernous angiomas may occur in children, as well as in familial forms, or in association with other visceral locations. It is important to know that some cavernous angiomas are able to grow, owing to a variety of mechanisms, which may result in rupture and cerebral hemorrhage. The improvement of both imaging and surgical techniques have reduced the risks of death or heavy sequelae. Some deeply located cavernous angiomas, however, are still inaccessible to surgery.
海绵状血管瘤是属于错构瘤类的血管畸形。缺乏支持某些颅内海绵状血管瘤是良性血管肿瘤这一假说的证据。由于它们在血管造影上隐匿，在CT扫描和MRI出现之前，海绵状血管瘤在很大程度上被忽视，被认为很罕见。这两种技术在癫痫、脑出血或颅内高压病例中都能提供快速准确的诊断。大多数半球海绵状血管瘤位于皮质下，在中央沟附近。在脑干中，它们大多可在脑桥中发现。小脑和脊髓很少受累。海绵状血管瘤可发生于儿童，也有家族性形式，或与其他内脏部位相关。重要的是要知道，一些海绵状血管瘤由于多种机制能够生长，这可能导致破裂和脑出血。成像技术和手术技术的改进降低了死亡或严重后遗症的风险。然而，一些深部海绵状血管瘤仍然无法进行手术。
