Cavernous angioma natural history, complications and prognosis: Difference between revisions
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{{Cavernous angioma}} | {{Cavernous angioma}} | ||
{{CMG}}; {{AE}} [[User:Edzelco|Edzel Lorraine Co, D.M.D., M.D.]] | {{CMG}}; {{AE}} [[User:Edzelco|Edzel Lorraine Co, D.M.D., M.D.]] | ||
==Overview== | ==Overview== | ||
[[Cavernous angioma]] is usually a [[benign]] course since it is a [[low-flow]] and [[low-pressure]] [[lesion]]. Patients with [[cavernous angioma]] have variable [[signs and symptoms]], with [[seizure]] as the most predominant [[symptom]], followed by [[hemorrhage]] and [[focal neurologic deficit]]. | [[Cavernous angioma]] is usually a [[benign]] course since it is a [[low-flow]] and [[low-pressure]] [[lesion]]. Patients with [[cavernous angioma]] have variable [[signs and symptoms]], with [[seizure]] as the most predominant [[symptom]], followed by [[hemorrhage]] and [[focal neurologic deficit]]. | ||
==Natural History== | ==[[Natural History]]== | ||
Once patients become symptomatic, 40-50% present with seizures, 20% present with [[focal neurologic deficits]], and 10-25% present with [[intracerebral parenchymal hemorrhage]].<ref name="pmid32524542">{{cite journal| author=Vercelli GG, Cofano F, Santonio FV, Vincitorio F, Zenga F, Garbossa D| title=Natural History, Clinical, and Surgical Management of Cavernous Malformations. | journal=Methods Mol Biol | year= 2020 | volume= 2152 | issue= | pages= 35-46 | pmid=32524542 | doi=10.1007/978-1-0716-0640-7_3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32524542 }} </ref> | Once patients become [[symptomatic]], 40-50% present with [[seizures]], 20% present with [[focal neurologic deficits]], and 10-25% present with [[intracerebral parenchymal hemorrhage]].<ref name="pmid32524542">{{cite journal| author=Vercelli GG, Cofano F, Santonio FV, Vincitorio F, Zenga F, Garbossa D| title=Natural History, Clinical, and Surgical Management of Cavernous Malformations. | journal=Methods Mol Biol | year= 2020 | volume= 2152 | issue= | pages= 35-46 | pmid=32524542 | doi=10.1007/978-1-0716-0640-7_3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32524542 }} </ref> | ||
==Complications== | ==[[Complications]]== | ||
*The risk of [[hemorrhage]] is not well established, but it is estimated to be 0.2-2% per lesion per year. | *The [[risk]] of [[hemorrhage]] is not well established, but it is estimated to be 0.2-2% per [[lesion]] per year. | ||
*This risk is increased in patients with established prior [[hemorrhage]]. | *This [[risk]] is increased in patients with established prior [[hemorrhage]]. | ||
*The clinical consequences of [[hemorrhage]] vary such that location becomes important. | *The clinical consequences of [[hemorrhage]] vary such that [[location]] becomes important. | ||
*Small [[hemorrhages]] in critical locations can have more severe effects, and thus, they are more likely to produce symptoms ( | *Small [[hemorrhages]] in critical locations can have more severe effects, and thus, they are more likely to produce [[symptoms]] (e.g. [[brainstem ]]involvement). | ||
*Progressive [[neurologic deficits]] are more often associated with [[cavernous]] [[malformations]] in the [[infratentorial space]] and with lesions that demonstrate slow enlargement because of [[rebleeding]] episodes. | *Progressive [[neurologic deficits]] are more often associated with [[cavernous]] [[malformations]] in the [[infratentorial space]] and with [[lesions]] that demonstrate slow enlargement because of [[rebleeding]] episodes. | ||
==Prognosis== | ==[[Prognosis]]== | ||
*The lesions do not usually produce life-threatening hemorrhages because most hemorrhages associated with the lesions are small and of low pressure. <ref name="pmid32524542">{{cite journal| author=Vercelli GG, Cofano F, Santonio FV, Vincitorio F, Zenga F, Garbossa D| title=Natural History, Clinical, and Surgical Management of Cavernous Malformations. | journal=Methods Mol Biol | year= 2020 | volume= 2152 | issue= | pages= 35-46 | pmid=32524542 | doi=10.1007/978-1-0716-0640-7_3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32524542 }} </ref> | *The [[lesions]] do not usually produce [[life-threatening]] [[hemorrhages]] because most [[hemorrhages]] associated with the [[lesions]] are small and of low [[pressure]]. <ref name="pmid32524542">{{cite journal| author=Vercelli GG, Cofano F, Santonio FV, Vincitorio F, Zenga F, Garbossa D| title=Natural History, Clinical, and Surgical Management of Cavernous Malformations. | journal=Methods Mol Biol | year= 2020 | volume= 2152 | issue= | pages= 35-46 | pmid=32524542 | doi=10.1007/978-1-0716-0640-7_3 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32524542 }} </ref> | ||
*Cavernous malformations can occur at any age, but they are most likely to become clinically apparent in patients aged 20-40 years. | *Cavernous malformations can occur at any age, but they are most likely to become clinically apparent in patients aged 20-40 years. | ||
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[[Category:Genetic disorders]] | [[Category:Genetic disorders]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category: | [[Category:Up to Date]] | ||
Latest revision as of 13:33, 12 May 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.
Overview
Cavernous angioma is usually a benign course since it is a low-flow and low-pressure lesion. Patients with cavernous angioma have variable signs and symptoms, with seizure as the most predominant symptom, followed by hemorrhage and focal neurologic deficit.
Natural History
Once patients become symptomatic, 40-50% present with seizures, 20% present with focal neurologic deficits, and 10-25% present with intracerebral parenchymal hemorrhage.[1]
Complications
- The risk of hemorrhage is not well established, but it is estimated to be 0.2-2% per lesion per year.
- This risk is increased in patients with established prior hemorrhage.
- The clinical consequences of hemorrhage vary such that location becomes important.
- Small hemorrhages in critical locations can have more severe effects, and thus, they are more likely to produce symptoms (e.g. brainstem involvement).
- Progressive neurologic deficits are more often associated with cavernous malformations in the infratentorial space and with lesions that demonstrate slow enlargement because of rebleeding episodes.
Prognosis
- The lesions do not usually produce life-threatening hemorrhages because most hemorrhages associated with the lesions are small and of low pressure. [1]
- Cavernous malformations can occur at any age, but they are most likely to become clinically apparent in patients aged 20-40 years.
References
- ↑ 1.0 1.1 Vercelli GG, Cofano F, Santonio FV, Vincitorio F, Zenga F, Garbossa D (2020). "Natural History, Clinical, and Surgical Management of Cavernous Malformations". Methods Mol Biol. 2152: 35–46. doi:10.1007/978-1-0716-0640-7_3. PMID 32524542 Check
|pmid=value (help).