• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.815-821
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• 2000

Parasplenial arteriovenous malformations(AVMs) are rare vascular malformations which have distinct clinical and anatomical features. They are situated at the confluence of the hippocampus, isthmus of the cingulate gyrus and the gyrus occipitotemporalis medialis. These lesions are anterior to the calcarine sulcus and their apex extends towards the medial surface of the trigonum. Posterolaterally, these lesions are in close proximity to the visual cortex and optic radiation. The objectives in the surgery of parasplenial AVMs are complete resection of the lesions and preservation of vision. These objectives must be achieved with comprehensive understanding of the following anatomical features :1) the deep central location of the lesions within eloquent brain tissue ; 2) the lack of cortical representation of the AVMs that requires retraction of visual cortex ; 3) deep arterial supply ; 4) deep venous drainage ; 5) juxtaposition to the choroid plexus with which arterial supply and venous drainage are shared. A 16-year-old female student presented with intraventricular hemorrhage from a right parasplenial-subtrigonal AVM. The lesion, fed by posterior cerebral artery and drained into the vein of Galen, was successfully treated by the inter-hemispheric parietooccipital approach. To avoid visual field defect a small incision was made on precuneus anterior to the calcarine sulcus. In this report, the authors describe a surgical approach with special consideration on preservation of visual field.

• Journal of Korean Neurosurgical Society
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• v.37 no.1
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• pp.34-38
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• 2005

Objective: Spontaneous intracranial hemorrhage in children is not common and very different compared to adults. We analyze the etiology, hemorrhagic type, clinical features, and outcome of spontaneous intracranial hemorrhage in children. Methods: Twenty-nine patients under 17years of age with nontraumatic intracranial hemorrhage were analyzed retrospectively. Neonates were excepted. We reviewed their medical records in regard to their age, symptoms, radiologic findings, treatment, and prognosis. Results: Among 29 patients, there were 17boys and 12girls. The average age was 10.2years. The most common presenting symptom was mental deterioration, and the most common cause was arteriovenous malformation. Spontaneous intracranial hemorrhage in children showed a better prognosis than in adults. Conclusion: Spontaneous intracranial hemorrhage in children resulted mainly from vascular malformation and the prognosis is relatively good. More careful follow-up studies and active management are needed for better outcomes.

• Journal of Chest Surgery
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• v.8 no.1
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• pp.13-18
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• 1975

Developmental pulmonary abnormalities are known as rare condition. diagnosis was made at autopsy in the early cases reported, however, as diagnostic aids such as X-ray, bronchography, bronchoscopy and exploratory thoracotomy have come into use, the condition is being discovered more often recently in living persons, and it appears to occur with sufficient frequency to merit consideration in the differential diagnosis of certain chest conditions. According to Schneider and Boyden there are three main types of this abnormality: [1] Agenesis, in which there is complete absence of one or both lungs; there is no trace of bronchial or vascular supply or of parenchymal tissue. [2] Aplasia, in which there is suppression of all but a rudimentary bronchus which ends in a blind pouch; there are no vessels or parenchyma. [3] Hypoplasia, in which the bronchus is fully formed but is reduced in size and ends in a _ flesh structure which usually lies within the mediastinum. Rudimentary pulmonary parenchyma may be present around the bronchial stump and often is the site of cystic malformation. We experienced one case of hypoplastic lung with cystic malformation which was originated from a small aberrant rudimentary bronchus, and the rudimentary bronchus was branched from the right side of tracheal end. The diagnosis was finally confirmed by the histopathological finding. Now, we report this case with a brief review of literatures.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.671-678
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• 2007

Purpose: Venous malformation(VM) which often causes pain and discomfort is the most common type of vascular malformations. Although it is presented with disfigured appearance and associated soft tissue or skeletal hypertrophy, the molecular bases of VMs are poorly understood. Differentially expressed genes(DEGs) of VMs were investigated to illuminate the molecular mechanism of the disease entity. Methods: Gene expressions of VM patients' subcutaneous tissue were studied in comparison with normal persons' by $GeneFishing^{TM}$ technique using the annealing control primers (ACPs) to identify DEGs. Candidate genes were sequenced and screened by basic local alignment search tool (BLAST) afterwards. Results: Among seventy DEGs identified, forty DEGs which had shown significantly different expression pattern were sequenced. Twenty eight out of 40 were up-regulated while 12 were down-regulated. BLAST searches revealed that 37 were known genes and 3 were unknown genes. Many genes were involved in the differentiation and remodeling of smooth muscle cells, opposed to the previous hypothesis that a lot of angiogenetic genes would be involved. Furthermore, several transcription factors and related genes, as well as cell signaling and metabolism regulators, were up regulated. Conclusion: It suggests that analysis of DEGs in VMs provide basic knowledge about its pathophysiology. and new therapeutic approaches.

• Journal of Korean Neurosurgical Society
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• v.58 no.6
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• pp.547-549
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• 2015

Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex. After warm saline irrigation of the mass, active bleeding developed from a one of the vessel. The bleeding was stopped by coagulation and the vessels were removed. Histopathological examination confirmed the lesion as an AVM. We concluded that a small cortical AVM existed at this area, and that the cortical AVM had caused the acute SDH. Follow up conventional angiography confirmed the absence of remnant AVM or any other vascular abnormality. This report demonstrates rupture of a cortical AVM is worth considering when a patient presents with non-traumatic SDH without intracerebral hemorrhage or subarachnoid hemorrhage.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.1-9
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• 2001

Purpose : To establish the role of stereotactic radiosurgery (SRS) for the treatment of patients with angiographically occult vascular malformation (AOVM). Materials and Methods : Eleven patients (12 lesions) with AOVM were treated with linear accelerator-based SRS between February 1995 and December 1999. A magnetic resonance imaging of each patients showed well-circumscribed vascular lesion with reticulated core of heterogeneous signal intensity and peripheral rim of low signal intensity. SRS were peformed with the median peripheral dose of 16 Gy (range 13~25). A single isocenter was used with median collimator size of 14 mm (range 8~20) diameter. Results : With a median follow-up period of 42 months (range 12~56), rebleeding occurred in 3 AOVMS at 5, 6 and 12 months after SRS but no further bleeding did. Two patients experienced radiation-induced necrosis associated with permanent neurologic deficit and one patient showed transient edema of increased 72 signal intensity. Conclusion : SRS may be effective for the prevention of rebleeding in AOVM located in surgically inaccessible region of the brain. Careful consideration should be needed in the decision of case selection and dose prescription because the incidence of radiation-induced complications is too high to be accepted.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.23-33
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• 2019

Background Venous malformations (VMs) are a common type of vascular malformation. However, their causes and management remain unclear, and few studies specific to VMs of the head and neck have been reported. This study describes our experiences with VMs of the head and neck. Methods This retrospective study included 82 patients who underwent treatment for head and neck VMs, among 222 who visited our vascular anomalies center. Medical records between 2003 and 2016 were reviewed to identify common features in the diagnosis and treatment. The diagnosis of suspected head and neck VMs was based on the results of imaging studies or biopsies, and the VMs were analyzed based on magnetic resonance imaging, computed tomography, and Doppler sonography findings. Results VMs were slightly more common in female patients (59.8%), and 45.1% of patients developed initial symptoms at the age of 10 or younger. Lesions were slightly more common on the right side (47.3%). The main sites involved were the cheek (27.7%) and lip area (25.5%). The muscle layer was commonly involved, in 98.7% of cases. Small lesions less than 5 cm in diameter accounted for 60.8% of cases, and well-defined types were slightly more prevalent at 55.4%. Improvement was observed in 77.1% of treated patients. Conclusions Early and accurate diagnosis and appropriate treatment according to individual symptoms are important for successful treatment of VMs. If treatment is delayed, the lesions can worsen, or recurrence becomes more likely. Therefore, VMs require a multidisciplinary approach for early and accurate diagnosis.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.10-18
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• 2016

Background Lymphatic malformation (LM) is a form of congenital vascular malformation with a low incidence. Although LM has been studied, no consensus has emerged regarding its cause or treatment. Methods In this study, we retrospectively evaluated 40 patients who visited our vascular anomalies center for the treatment of cervicofacial LM, which is a common manifestation of LM. The medical records of patients over a period of 12 years were reviewed and analyzed for commonalities regarding the diagnosis and the results of treatment. Results Suspected cervicofacial LM was confirmed through imaging studies. No difference in incidence was observed according to sex, and 73% of patients first presented with symptoms before the age of two years. The left side and the V2-V3 area were most commonly affected. No significant differences in incidence were observed among the macrocystic, microcystic, and combined types of LM. A total of 28 out of 36 patients received sclerotherapy as the first choice of treatment, regardless of the type of lesion. Complete resolution was achieved in only 25% of patients. Conclusions LM is important to confirm the diagnosis early and to choose an appropriate treatment strategy according to the stage of the disease and each individual patient's symptoms. When treatment is delayed or an incorrect treatment is administered, patient discomfort increases as the lesion gradually spreads. Therefore, more so than is the case for most other diseases, a team approach on a case-by-case basis is important for the accurate and appropriate treatment of LM.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.1018-1023
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• 2021

A meandering pulmonary vein (MPV) is a rare pulmonary vascular anomaly characterized by an abnormal course of the pulmonary vein draining into the left atrium. We report the case of a 55-year-old female who was diagnosed with a right MPV on pulmonary angiography. Enhanced chest CT revealed a vascular structure with an abnormal course that drained into the right superior pulmonary vein in the right upper lobe, which resembled a pulmonary arteriovenous malformation (AVM). Pulmonary angiography performed to discriminate between an MPV and pulmonary AVM showed no feeding artery, normal parenchymal staining, and drainage to the left atrium via the culprit vessel. Thus, the patient was diagnosed with MPV. When an MPV is difficult to differentiate from other vascular anomalies on enhanced chest CT, pulmonary angiography can be helpful. By recognizing the angiographic findings of an MPV, unnecessary treatment can be prevented.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.610-614
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• 2003

Pulmonary hypertension may be associated with variable conditions such as the hyperkinetic state or pulmonary vascular obstruction. In these, stenosis of the individual pulmonary veins without any cardiac or vascular malformation is very rare. We experienced stenosis of individual pulmonary veins in a 10 months old boy who was admitted with recurrent dyspnea and cyanosis and then underwent angiogram and a lung perfusion scan.