Abstract

Vascular malformations of central nervous system: A series from tertiary care hospital in South India.

Karri, Sudhir Babu Uppin, Megha S. Rajesh, A. Ashish, K. Bhattacharjee, Suchanda Rani, Y. Jyotsna Sahu, B. P. Saradhi, M Vijaya Purohit, A. K. Challa, Sundaram

Abstract


Aims and Objectives:: To describe clinicopathological features of surgically resected vascular malformations (VMs) of central nervous system (CNS). Materials and Methods:: Histologically diagnosed cases of VMs of CNS during April 2010April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG), Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs) were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results:: Fifty cases were diagnosed as VMs of CNS with an age range of 1462 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36) presented with seizures, whereas AVM patients (8/12) had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions:: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage.


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