Gülşen Salih, Altinörs Nur, Atalay Başar, Benli Sibel, Kaya Yildiz
Başkent University, School of Medicine, Department of Neurosurgery, Bahçelievler, Ankara, Turkey.
Turk Neurosurg. 2007;17(1):40-4.
Venous angiomas were found to be the most common cerebral vascular malformations, composing 63% of such lesions in two autopsy series. Annual bleeding risk associated with venous angiomas is about 0.22 % per year. Venous angiomas are generally silent lesions because of their dynamic features, and are low flow and low pressure vascular structures draining normal brain tissue. An angioma rarely causes symptoms such as bleeding, seizure, hemifacial spasm, trigeminal neuralgia, aqueduct compression, nonhemorrhagic infarction and thrombosis of the draining vein. Even if it should bleed, the lesion can be managed conservatively in asymptomatic or mildly symptomatic patients. In this paper we report two venous angioma cases. The first patient bled twice in a short period of time and the angioma was located at the posterior fossa next to the left lateral recess. The second patient recently suffered a cerebral stroke that was located in the vicinity of the right caudate nucleus and not associated with the venous angioma that was located next to the left caudate nucleus. This patient had been under warfarin sodium treatment for 14 years due to his previous coronary artery bypass surgery, but unknowingly there was a venous angioma located next to the caudate nucleus.
静脉血管瘤被发现是最常见的脑血管畸形,在两个尸检系列中占此类病变的63%。与静脉血管瘤相关的年出血风险约为每年0.22%。由于其动态特征,静脉血管瘤通常是无症状的病变,是引流正常脑组织的低流量、低压血管结构。血管瘤很少引起出血、癫痫、半面痉挛、三叉神经痛、导水管受压、非出血性梗死和引流静脉血栓形成等症状。即使出血,对于无症状或症状轻微的患者,该病变也可保守处理。在本文中,我们报告了两例静脉血管瘤病例。第一例患者在短时间内出血两次,血管瘤位于后颅窝左侧外侧隐窝旁。第二例患者最近发生了一次脑卒中,位于右侧尾状核附近,与位于左侧尾状核旁的静脉血管瘤无关。该患者因先前的冠状动脉搭桥手术接受华法林钠治疗14年,但尾状核旁存在静脉血管瘤却未被发现。