What is Positional Plagiocephaly?

Cerebrovascular malformations are congenital, non-neoplastic developmental abnormalities of the cerebral blood vessels. It refers to abnormalities in the number and structure of local blood vessels in the brain caused by cerebrovascular development disorders, and has an impact on normal cerebral blood flow. Ruptured bleeding is mainly manifested as intracranial hemorrhage or hematoma. It is more common in young people, with an average age of onset of 20 to 40 years.

Basic Information

nickname

Cerebral hemangiomas; cerebral arteriovenous vascular malformations

English name

vascular malformations ofbrain

Visiting department

surgical

Common causes

Arteriovenous malformation; Congenital intracranial cystic aneurysm; Venous hemangioma; Cavernous hemangioma

Common symptoms

Pulsatile headache; subarachnoid hemorrhage or intracerebral hematoma; epilepsy, etc.

Causes of cerebrovascular malformations

Arteriovenous malformation

They are divided into two types: typical and Galen's great venous malformations: in addition to the clinical symptoms of placeholder and compression, stealing blood is also an important cause. Intracranial vascular murmur is obvious. Hydrocephalus can occur during infancy. The case fatality rate is high, with approximately 50% of deaths. Those with low blood flow have mild heart failure and may have repetitive transient hemiplegia. Treatment is difficult and staged surgery is available.

2. Congenital intracranial cystic aneurysm

Rarely seen in children. It mainly occurs in the internal carotid artery at the base of the skull, anterior and posterior communicating arteries, or vertebrobasilar arteries. The elastic and muscular layers of the arteries are weakened, and the protrusion is a tumor, usually below 1 cm.

3. Venous hemangioma

More common, occurs in the cerebral hemisphere, and is more common in older children. Neuroimages show vascular malformations with a diameter of 1 mm to several centimeters, and about 15% have calcification.

4. cavernous hemangioma

It is more common in the cerebral hemisphere and is a dense, thin-walled blood vessel. Childhood is often asymptomatic and is found by accident. Symptoms usually occur in older children or adults, mainly epilepsy, headache, and intra-brain hemorrhage. Common familial cases are dominant. Similar cavernous hemangioma of the retina, liver, kidney, and skin can also be seen in this disease.

Clinical manifestations of cerebrovascular malformations

Throbbing headache

It is located on the diseased side and may be accompanied by intracranial vascular noise.

2. bleeding

Often the first symptom, manifested as subarachnoid hemorrhage or intracerebral hematoma.

3. Epilepsy

It can be the first symptom or seen after bleeding, mostly systemic or localized, localized localized.

4. Accompanying symptoms

Patients with on-screen lesions may have mental disorders, hemiplegia, aphasia, aphasia, and miscalculation. People below the scene often see dizziness, diplopia, nystagmus, and gait instability.

Cerebrovascular malformation

Plain skull

It shows that the middle meningeal artery is tortuous and widened, suggesting that deformed blood vessels are possible.

2.Head CT

Hematomas can be found and the possibility of providing malformed blood vessels.

3. Head magnetic resonance

Better than CT, not only can display abnormal blood vessels and their relationship with surrounding brain tissue, but also distinguish between bleeding and calcification.

4. Cerebral angiography

It is the most reliable and main diagnostic method for this disease, and can perform endovascular interventional treatment.

Cerebrovascular malformation diagnosis

Diagnosis can be confirmed based on clinical manifestations combined with laboratory tests.

Cerebrovascular malformation treatment

Surgical treatment

2. Endovascular interventional therapy

3. Stereotactic radiation therapy (-knife, X-knife)

4. Treatment of spontaneous bleeding

5. Symptomatic treatment

6. Medication Principle

(1) When spontaneously exuding blood, immediately use a hemostatic agent such as 6-aminocaproic acid. The main method for reducing the intracranial pressure is 20% mannitol or furosemide. If necessary, use human albumin.

(2) For long-term systemic treatment of patients with epilepsy, according to the type of epilepsy, phenytoin sodium, valproate sodium, carbamazepine are selected, and barbiturates are used if necessary.

(3) Other symptoms, symptomatic and supportive treatment.