Excision of cavernous angioma with preservation of coexisting venous angioma

Case report

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✓ The case of a patient presenting with dysphasic seizures due to a cavernous angioma coexisting with a venous malformation is reported. The cavernous angioma was resected with preservation of the venous malformation, as confirmed by postoperative studies. The patient was seizure-free following surgery.

Article Information

Address reprint requests to: Osamu Sasaki, M.D., Department of Neurosurgery, Kuwana Hospital, 6–4 Furukawacho, Niigata City 950, Japan.

© AANS, except where prohibited by US copyright law.

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Figures

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    Preoperative studies. A: Postcontrast computerized tomography scan demonstrating a curvilinear enhancement. B: Magnetic resonance T2-weighted image depicting a core of mixed intensity with a rim of decreased intensity.

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    Preoperative left internal carotid angiogram showing a typical venous malformation in the left temporal lobe.

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    Schematic drawing of the intraoperative view. CA = cavernous angioma; MV = central medullary vein of the venous malformation; DV = draining vein.

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    Photomicrograph of the surgical specimen. The lesion is composed of sinusoidal vascular spaces of various sizes lined by a single layer of endothelium. Intervening neural tissue is absent in the intraparenchymal lesions, and the vessel walls are devoid of smooth-muscle and elastic tissue. These findings are typical of cavernous angiomas. Elastica Goldner stain, × 115.

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    Postoperative magnetic resonance studies, enhanced T1-weighted image (A) and T2-weighted image (B), revealing disappearance of the cavernous angioma and preservation of the central medullary vein of the venous malformation.

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    Postoperative left internal carotid angiogram showing preservation of the venous malformation. There are slightly fewer small veins converging into the central medullary vein than preoperatively.

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