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2 results

  • Bleomycin for Head and Neck Venolymphatic Malformations: A Systematic Review

  • Stephanos Finitsis, Khunsa Faiz, Janice Linton, Jai Jai Shiva Shankar
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 48 / Issue 3 / May 2021
    Published online by Cambridge University Press:
    17 August 2020, pp. 365-371
    • Article
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  • Background:

    Venolymphatic malformations are rare benign vascular lesions of the head and neck. Sclerotherapy has become the first-line therapy of these lesions with bleomycin being a sclerosing agent commonly used.

    Purpose:

    To perform a systematic review of the published literature to synthesize evidence on the safety and efficacy of bleomycin for the treatment of head and neck venolymphatic malformations.

    Data sources:

    A systematic review of the literature (January 1995–May 2019) was performed in PubMed, Embase, and Cochrane Library databases to identify studies on sclerotherapy of venolymphatic malformations of the head and neck.

    Study selection:

    A total of 32 studies with participants met the inclusion criteria among which 1121 patients were included in the systematic review.

    Data analysis:

    Two reviewers independently screened and extracted data and assessed the risk of bias. The primary outcome was the subjective or objective reduction of lesion size as well as minor and major complications.

    Data synthesis:

    The bleomycin/pingyangmycin sclerotherapy achieved subjective or objective lesion size reduction in 96.3% (95% CI 94.1%–98.5%) of patients. Minor complications were observed in 16.2% and major complications in 1.1%.

    Conclusion:

    Bleomycin is a highly effective treatment of venolymphatic malformations of the head and neck with a low rate of major adverse events. This study represents an update on the “available” evidence, but only low-to-moderate quality studies were available.

    Limitations:

    This study reviewed 32 studies performed in different parts of the world, but there was heterogeneity of the study designs and interventions.

  • 37 - COGAN’S SYNDROME

  • from PART III: - VASCULAR CONDITIONS OF THE EYES, EARS, AND BRAIN
  • Edited by Louis R. Caplan, Julien Bogousslavsky
  • Book:
    Uncommon Causes of Stroke
    Published online:
    06 January 2010
    Print publication:
    09 October 2008, pp 259-262

  • Summary

    There are four types of cerebral vascular malformations: arteriovenous malformations (AVMs), cavernous malformations (CMs), capillary telangiectasies, and venous malformations. This chapter presents a review of the pertinent literature on CMs regarding epidemiology, genetics, pathology, clinical findings, and therapeutic management with special emphasis placed upon the natural bleeding risk of these malformations. The most sensitive imaging study to detect CMs is magnetic resonance imaging (MRI). Predictive factors for intracranial hemorrhage in patients harboring CMs is a critical issue because the optimal therapeutic management of such lesions is tailored according to the bleeding risk. The main goal of radiosurgical treatment should be a significant reduction in bleeding risk, especially after a latency period of 2 years. By genetic linkage analyses, three cerebral CM loci have been assigned to chromosome 7p, 7q, and 3q. They account for all familial forms of CM, thus constituting a formidable Mendelian model of stroke.