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Multilobular cavernous malformation: report of two cases

K Mishima1, T Sasaki, T Ojima

  • 1Department of Neurosurgery, Faculty of Medicine, University of Tokyo, Japan.

Acta Neurochirurgica
|April 2, 1998
PubMed
Summary
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Multilobular cavernous malformations, appearing as separated nests on MRI, can recur after surgery. This unique structure explains rebleeding from residual lesions in patients with brain vascular malformations.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Cavernous malformations are common vascular malformations in the brain.
  • Surgical resection is a primary treatment for symptomatic lesions.
  • Understanding malformation architecture is crucial for predicting treatment outcomes.

Observation:

  • Two cases of cavernous malformation with a distinct multilobular appearance on magnetic resonance imaging (MRI) were analyzed.
  • Surgical exploration revealed malformations composed of multiple angiomatous nests separated by normal brain tissue.
  • These nests were interconnected by small vascular channels.

Findings:

  • The multilobular architecture, with separated nests, challenges complete surgical excision.
  • This configuration can lead to the presence of residual malformation tissue post-surgery.

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  • The interconnected nature of the nests facilitates potential rebleeding from remaining lesions.

    • Implications:

    • The findings suggest that the inherent structure of multilobular cavernous malformations contributes to postoperative recurrence.
    • This anatomical characteristic may explain unexpected rebleeding events after seemingly complete resection.
    • Further research into surgical techniques and imaging interpretation for these specific malformations is warranted.