S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) The Seoul Journal of Medicine The Seoul Journal of Medicine Vol. 32 No.2 (1991)
Clinical Features of Angiographically Occult Vascular Malformation
뇌혈관 조영술 상 잠재성인 뇌혈관 기형의 임상적 특성
- Lee, Sun Ho; Cho, Byung Kyu; Han, Dae Hee
- Issue Date
- Seoul J Med, Vol.32 No.2, pp. 75-82
- Angiographically occult vascular malformation (AOVM); Arteriovenous malformation; Venous angioma; Cavernous angioma; Hemorrhage; Seizure; Rebleeding
- A retrospective review of 22 cases of angiographically occult vascular malformations
(AOVMs), treated at our institution during the past 6 years, was conducted
to define better the clinical and radiological manifestations as well as the effective
treatment modality of these lesions. There were 12 (54.5%) arteriovenous malformations
(AVMs), 8 (36.4%)cavernous angiomas, 1 (4.5%) venous angioma, and 1 (4.5%) unclassified
The most frequent initial presentations included hemorrhages in 72.7% of the patients,
seizures in 22.7%, and compression by mass lesion in 4.5%. Of the 16 hemorrhagic
cases, 11 (58.7%) were AVMs and 3 (18.7%) were cavernous angiomas. The remaining
2 cases were a venous angioma and an unclassified vascular malformation. In almost
all of the AVMs (11/12) the initial presentations were hemorrhages. Nine cases of AOVMs
(40.9%) developed recurrent hemorrhages as confirmed by clinical, radiological,
and operative features.
All of the MRI findings performed in the 17 cases showed thick circumscribed hypodense
rims on T2-weighted images representing hemosiderin deposits. Various central
intensities suggested the presence of hematomas in different stages.
Twenty patients underwent surgery with total excision and subsequent good results.
Two patients, one with a pontine lesion and the other with a middle cerebellar peduncle
lesion, underwent partial excision associated with consequent persistent neurological
This report suggests that the AOVMs are prone to cause hemorrhages or neurological
deficit and surgical excision can provide an effective and safe treatment modality for
this disease entity.