[Clinical study on six cases of subcortical cavernous angiomas]

Abstract

Cavernous angioma is a rare but important clinical entity because of its potential curability. We experienced with 6 cases of cavernous angiomas located in the subcortical region and summarized with special respect on clinical symptoms, CT scan, angiographic manifestations and operative findings. In all of these 6 cases, the diagnosis is confirmed as cavernous angioma histologically. The age in these cases ranged from 16 to 45 years and sex distribution was 3 males and 3 females. Initial symptoms of 6 cases were long-standing epilepsy in 4 cases and attack of unconsciousness in 2 cases. Plain craniogram revealed calcification in only one patient. On the other hand, plain CT scan showed high density areas in all cases. Among these, 3 patients showed slight contrast enhancement. Perifocal low density areas were noted in all cases and these low density areas extended to the cortical region. The most important lesion to differentiate from cavernous angioma is low-grade astrocytoma with calcification on CT scan. We misdiagnosed in one patient with cavernous angioma as contusional hemorrhage, because the patient fell unconscious and hit the occiput. Angiographically, most cavernous angiomas are represented as avascular masses with displacement of adjacent vessels. In contrast to this general acceptance, 4 out of the present 6 cases showed abnormal findings such as feeding artery, capillary blush and draining vein. The draining veins were encountered in 4 cases. It must be emphasized that these angiographic manifestations are very small and caution has to be paid not to be overlooked. From the operative view, there are several characteristic findings.(ABSTRACT TRUNCATED AT 250 WORDS)