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Cerebral cavernous angiomas in the first year of life
M Gangemi1, P Longatti, F Maiuri
1Institute of Neurosurgery, 2nd School of Medicine, University of Naples, Italy.
Insights
Cerebral cavernous angiomas are rare in infants, presenting with seizures and head enlargement. Surgical removal is often successful due to the well-defined nature of these brain lesions.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Neuroradiology
Background:
- Cerebral cavernous angiomas (CCAs) are uncommon vascular malformations of the brain.
- CCAs occurring in the first year of life are exceptionally rare, posing diagnostic and management challenges.
Observation:
- This report details two infant cases of CCA and reviews eleven similar cases from existing literature.
- Infantile CCAs typically manifest with seizures and progressive head enlargement.
- Computed tomography (CT) scans reveal large, hyperdense, unenhanced masses with cystic components.
Findings:
- CCAs in infants must be differentiated from more common pediatric brain tumors like teratomas and ependymomas.
- Despite their size, CCAs often have minimal bleeding and well-defined margins.
- Complete surgical resection is frequently achievable for these lesions.
Implications:
- Early recognition and accurate diagnosis of infantile CCAs are crucial for appropriate management.
- Surgical intervention offers a viable and often successful treatment option for pediatric CCAs.
- Further research into the etiology and long-term outcomes of infantile CCAs is warranted.
Abstract:
Two rare cases of cerebral cavernous angiomas in two infants, 9 and 6 months old, respectively, are reported and the other 11 cases in the literature concerning patients in the first year of life are reviewed. Cavernous angiomas of the brain occur rarely in the first year of life and present with seizures and head enlargement. On computed tomographic scan they typically appear as large, hyperdense, unenhanced masses, with large cysts and must be differentiated from tumors more common in infants, such as teratomas, ependymomas, and mixed tumors. Total removal is often possible, even with large lesions, because of the small amount of bleeding and the well-defined limits of the mass.