Symptomatic capillary telangiectasia of the pons and intracerebral developmental venous anomaly – a rare association [Simptomatska kapilarna teleangiektazija ponsa i intracerebralna razvojna venska anomalija: prikaz slučaja]

Šarac, Helena and Telarović, Srđana and Markeljević, Jasenka and Perić, Berislav and Pavliša, Goran and Radoš, Marko (2011) Symptomatic capillary telangiectasia of the pons and intracerebral developmental venous anomaly – a rare association [Simptomatska kapilarna teleangiektazija ponsa i intracerebralna razvojna venska anomalija: prikaz slučaja]. Collegium Antropologicum, 35 (S. 1). pp. 333-338. ISSN 0350-6134

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Abstract

Various combinations of vascular malformations of the brain in one lesion have been reported, while others seem to be very rare. In this report, the authors discuss the case of a coexistence of an capillary telangiectasia of the pons and intracerebral venous anomaly. To our knowledge, this is the first report of coexistence of a capillary telangiectasia of the pons and intracerebral venous anomaly apparted from each other. These discrete vascular malformations of the brain raise attention on possible interrelations in the pathogenesis of these entities. We report a case of pontine capillary telangiectasia and intracerebral venous anomaly in a 42-year-old woman with a right side facial palsy. Hight field magnetic resonance imaging suggested presence of a capillary telangiectasia of the pons. Another lesion in the left frontal gyrus was attributable to the venous anomaly. Along with neuroradiological findings, results of the somatosensor evoked potentials, brain stem auditory potentials, laboratory analysis including blood, cerebrospinal fluid and urine investigation are demonstrated. Awareness of the magnetic resonance imaging finding of the capillary telangiectasias and of the venous anomalies may help in defining clinical correlates of this vascular malformations, while the follow up of these malformations might help to asses risk of vascular rupture. We and others previously selects capillary telangiectasia and venous anomaly in two discrete entities. Coexistence of these malformations in the brain apparted from each other appear to be very rare and raise attention on possible interactions in their natural history and pathogenesis.

Abstract in Croatian

Do sada su opisivane različite kombinacije krvožilnih malformacija mozga unutar jedne lezije, dok su ostale kombinacije vjerojatno vrlo rijetke. U ovom članku, autori raspravljaju primjer koegzistencije kapilarne telangiektazije u ponsu i intracerebralne venske anomalije. Prema našim spoznajama, ovo je prvi slučaj u kojem se opisuje istovremena prisutnost kapilarne telangiektazije i razvojne venske anomalije mozga udaljene jedna od druge. Ove diskretne vaskularne malformacije mozga pobuđuju na razmišljanje o mogućoj povezanosti patogeneza ovih dvaju entiteta. Opisujemo slučaj kapilarne telangiektazije u ponsu i intracerebralne venske anomalije u 42-godišnje bolesnice s paralizom desne polovice lica. Magnetska rezonancija pokazala je kapilarnu telangiektaziju u ponsu, dok druga lezija u lijevom čeonom girusu odgovara razvojnoj venskoj anomaliji. Uz neuroradiološke nalaze, prezentirani su i rezultati somatosenzornih evociranih potencijala (SSEP), auditornih potencijala moždanog debla (BAEP), laboratorijske nalaze krvi, urina i cerebrospinalnog likvora. Prepoznavanje nalaza kapilarne telangiektazije i venske anomalije na magnetskoj rezonanciji može pomoći u definiranju kliničkih poveznica obiju vaskularnih malformacija, dok praćenje ovih malformacija može pomoći u procjeni rizika od vaskularne rupture. Mi i drugi prije nas, izdvajamo kapilarne telangiektazije i razvojne venske anomalije u dva diskretna entiteta. Koegzistencija ovih malformacija u mozgu odvojeno jedna od druge, pobuđuje zanimanje o mogućim interakcijama u njihovom nastanku, patogenezi i terapijskim mogućnostima.

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