By H. W. Pia (auth.), H. W. Pia, J. R. W. Gleave, E. Grote, J. Zierski (eds.)
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Additional info for Cerebral Angiomas: Advances in Diagnosis and Therapy
As a rule, they cross the midline and must therefore be classified in the above-mentioned group. All angiomas of the posterior fossa that involve the medulla, the pons and the midbrain belong here. In Table 1 the locations of interest are listed together once more. For these angiomas the indication for operation was limited till now, or there was actually a contraindication to total removal. Table 1. , pallidum, putamen, claustrum Unilateral angiomas huge, in functional important areas On surveying the literature and studying our own cases, we gained the impression that angiomas in the basal ganglia and the corpus callosum possess certain peculiarities in the clinical presentation.
Four of the patients had hemorrhage and seizures. The convulsions preceded the time of diagnosis by one to 23 years. Headache was the main complaint in 17 patients, including 11 who bled. Neurologic deficits were present in 15 patients and included paresis, sensory loss, visual loss, cranial nerve signs, and hydrocephalus in 2 cases. They were more frequent and perhaps more severe than in the usual convexity AVM. Five of the 27 patients had neither convulsions nor hemorrhage. Three of them presented initially with neurological deficit and 2 with headache only.
Convulsions were more frequent in males, and were present before the age of 20 in 27% of the patients. Headache was the most frequent symptom (52%). It nearly always accompanied hemorrhage. 46 patients had neurologic deficits when first examined; the most common being visual fields defects, hemiparesis, speech difficulties, and sensory disturbances. Cranial bruit was heard in 22 patients (11 with cranial and extracranial AVM and 11 with intracranial lesions). Mental disturbances were uncommon (4%).