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The Case for Conservative Management of Venous Angiomas

Published online by Cambridge University Press:  18 September 2015

Douglas Kondziolka ,
Peter K. Dempsey  and
L. Dade Lunsford
Douglas Kondziolka
Affiliation:
Department of Neurological Surgery, Presbyterian-University Hospital, University of Pittsburgh, Pittsburgh
Peter K. Dempsey
Affiliation:
Department of Neurological Surgery, Presbyterian-University Hospital, University of Pittsburgh, Pittsburgh
L. Dade Lunsford*
Affiliation:
Department of Neurological Surgery, Presbyterian-University Hospital, University of Pittsburgh, Pittsburgh
*
Professor of Neurological Surgery, University of Pittsburgh School of Medicine, Room 9402, Presbyterian-University Hospital, Pittsburgh, Pennsylvania, USA 15213
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Abstract:

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Venous angiomas (developmental venous anomalies) are vascular malformations increasingly recognized in general neurosurgical or neurological practice. They are associated with intracranial hemorrhage, seizures, or progressive neurological deficits or found as incidental findings in patients who present with headaches or have neuroimaging studies for investigation of unrelated neurological disorders. Since venous angiomas drain normal cerebral tissue within a functionally normal arterial territory, resection can lead to venous infarction. This report studies 27 patients with venous angiomas, all of whom had conservative treatment. The venous angioma was considered to be responsible for the onset of neurological symptoms in 14 patients (7 with hemorrhage, 3 with hemorrhage and seizures, 2 with seizures, one with an extrapyramidal movement disorder, and one with motor deficit). Thirteen patients had incidental lesions (8 with headache, and 5 with unrelated neurological symptoms). Ten venous angiomas were in the posterior fossa; seven in the cerebellum. Location did not correlate with symptomatic presentation. No patient with hemorrhage required surgical evacuation of the hematoma. No patient died or had significant morbidity during the follow-up interval (mean of 3.7 years). Venous angiomas are low flow, low resistance vascular malformations, many of which are not associated with neurological sequelae. Our series supports the concept that surgical removal or radiosurgical obliteration should not be performed unless a patient has a second life threatening hemorrhage.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 18 , Issue 3 , August 1991 , pp. 295 - 299
Copyright
Copyright © Canadian Neurological Sciences Federation 1991

References

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