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- $Unique_ID{BRK04309}
- $Pretitle{}
- $Title{Vascular Malformations of the Brain}
- $Subject{Vascular Malformations of the Brain Intracranial Vascular
- Malformations Occult Intracranial Vascular Malformations Cerebral
- Malformations Arteriovenous Malformations Cavernous Malformations Venous
- Malformations Telangiectasias Moyamoya Disease Cerebrovascular Accident
- (Stroke) }
- $Volume{}
- $Log{}
-
- Copyright (C) 1989 National Organization for Rare Disorders, Inc.
-
- 642:
- Vascular Malformations of the Brain
-
- ** IMPORTANT **
- It is possible that the main title of the article (Vascular Malformations
- of the Brain) is not the name you expected. Please check the SYNONYM listing
- to find the alternate names and disorder subdivisions covered by this
- article.
-
- Synonyms
-
- Intracranial Vascular Malformations
- Occult Intracranial Vascular Malformations
- Cerebral Malformations
-
- Disorder Subdivisions:
-
- Arteriovenous Malformations
- Cavernous Malformations
- Venous Malformations
- Telangiectasias
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Moyamoya Disease
- Cerebrovascular Accident (Stroke)
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Vascular Malformations of the Brain are conditions that affect the blood
- vessels in the brain. They may be classified into four groups:
- Arteriovenous Malformations (abnormal arteries and veins), Cavernous
- Malformations (enlarged blood-filled spaces), Venous Malformations (abnormal
- veins), and the Telangiectasias (enlarged capillary-sized vessels). Symptoms
- and progression of these disorders vary with the type and severity of the
- malformations.
-
- Symptoms
-
- Vascular Malformations of the Brain may cause headaches, seizures, strokes,
- or bleeding in the brain (cerebral hemorrhage). Some researchers believe
- that the type of malformation determines the symptoms and progression of the
- disease. Other researchers believe that only the severity rather than the
- type of malformation is important.
-
- Arteriovenous Malformations or AVM's affect arteries, veins, and middle-
- sized vessels but not capillaries. These blood vessels are enlarged and
- twisted. Arteries and veins may be connected directly instead of being
- connected through fine capillaries. (For more information on this disorder
- choose "Arteriovenous" for your search term in the Rare Disease Database.)
-
- Cavernous Malformations consist of abnormally enlarged collections of
- blood-filled spaces. Cavernous Malformations may also be called Cavernous
- Angiomas or Cavernous Hemangiomas.
-
- Venous Malformations involve only the veins; they vary in size but do not
- involve the arteries. The veins may be enlarged and twisted. These abnormal
- veins may compensate for a lack of normal veins in another area of the brain.
-
- Telangiectasias result from enlarged openings (dilation) of capillary-
- sized vessels. Telangiectasias may occur on the face, eyes, membranes that
- cover the brain and spinal cord (meninges), and mucous membranes (the thin
- moist layer lining the body's internal surfaces).
-
- Causes
-
- The cause of Vascular Malformations of the Brain may be either congenital or
- acquired. It may be inherited as an autosomal dominant trait with variable
- expression and incomplete penetrance.
-
- Human traits including the classic genetic diseases, are the product of
- the interaction of two genes for that condition, one received from the father
- and one from the mother. In dominant disorders, a single copy of the disease
- gene (received from either the mother or father) will be expressed
- "dominating" the normal gene and resulting in appearance of the disease. The
- risk of transmitting the disorder from affected parent to offspring is 50%
- for each pregnancy regardless of the sex of the resulting child. Incomplete
- penetrance means that all characteristics of a particular trait may not be
- manifested in all those who inherit the gene.
-
- Malformations may also be the result of an injury or trauma. Symptoms
- may appear because the injured blood vessels may have very small
- malformations or lesions, a blood clot (thrombosis) may slow the blood flow,
- or slight bleeding may effect nearby tissues in the brain.
-
- Affected Population
-
- Vascular Malformations of the Brain affect males and females in equal
- numbers. A hereditary form of Cavernous Malformations tends to occur more
- frequently in Mexican-Americans. Arteriovenous Malformations occur more
- frequently in males.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Vascular
- Malformations of the Brain. Comparisons may be useful for a differential
- diagnosis:
-
- Cerebrovascular Accidents (Strokes) occur because the blood supply to the
- brain has been cut off or decreased.
-
- Thrombotic strokes occur when a clot has narrowed or completely closed an
- artery in the neck or head. This is usually the result of the buildup of
- fat-containing materials and calcium (plaque) on the inner linings of the
- blood vessels (atherosclerosis or hardening of the arteries).
-
- Embolic strokes occur when a clot breaks away from a diseased artery in
- another part of the body or the heart and clogs a smaller artery in the
- brain.
-
- Hemorrhagic strokes occur when a blood vessel ruptures in or around the
- brain, depriving that area of circulating blood.
-
- Each type of stroke has its own symptoms, progression, and prognosis.
- Clumsiness, headaches, speech difficulties, weakness or paralysis of one or
- both sides of the body may occur. Stiff neck, nausea, vomiting, and loss of
- consciousness are also common symptoms.
-
- Moyamoya Disease is a progressive disease that effects blood vessels in
- the brain (cerebrovascular). It is characterized by narrowing and/or closing
- of the main artery to the brain (carotid) which decreases the blood supply.
- This lack of blood may cause semi- or complete paralysis of the feet, legs or
- the upper extremities. Cerebral bleeding, convulsions, headaches, various
- vision problems, mental deficiencies, and psychiatric problems may also
- occur. (For more information on this disorder, choose "Moyamoya" as your
- search term in the Rare Disease Database.
-
- Therapies: Standard
-
- Imaging machines such as Digital Intravenous Computerized or Common
- Angiography, Magnetic Resonance Imaging (MRI), Computed Tomography (CT)
- Scans, and Venograms can take pictures of the brain's blood vessels to see if
- Vascular Malformations are present.
-
- Current treatment options vary according to the severity and location of
- the malformation. Surgical Removal (Resection), Multiple Embolization (an
- operation in which pellets are put into the circulatory system in order to
- block the abnormal blood vessels), and Irradiation are the treatments
- currently in use. In some cases treatment may not be necessary.
-
- Genetic counseling may be of benefit for patients and their families if
- they have a hereditary form of this disorder. Other treatment is symptomatic
- and supportive.
-
- Therapies: Investigational
-
- Researchers are investigating several types of surgery that may be effective
- in treating Vascular Malformations of the Brain. Charged-Particle
- Radiosurgery, Interventriculostomy, and Catheter Placement are being studied.
- Charged-Particle Radiosurgery involves a needlelike surgical instrument which
- uses charged particles to cut tissue, to sterilize the edges of the wound,
- and to seal cut blood vessels. Interventriculostomy involves creating an
- opening in the brain to drain fluid. Catheters may be placed in the brain to
- drain any excess fluid and to collapse the malformed vessels.
-
- This disease entry is based upon medical information available through
- April 1989. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Vascular Malformations of the Brain, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Institute of Neurological Disorders & Stroke (NINDS)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5751
- (800) 352-9424
-
- For genetic information and genetic counseling referrals:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10505
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- VASCULAR MALFORMATIONS OF THE BRAIN: B.M. Stein & J.P Mohr; N Engl J Med
- (August 11, 1988: issue 319(6)). Pp. 368-370.
-
- CEREBRAL CAVERNOUS MALFORMATIONS: INCIDENCE AND FAMILIAL OCCURRENCE: D.
- Rigamonti et al.; N Engl J Med (August 11, 1988: issue 319(6)). Pp. 343-
- 347.
-
- CLINICAL, RADIOLOGICAL, AND PATHOLOGICAL SPECTRUM OF ANGIOGRAPHICALLY
- OCCULT INTRACRANIAL VASCULAR MALFORMATIONS. ANALYSIS OF 21 CASES AND REVIEW
- OF THE LITERATURE: R.D. Lobato et al.; J Neurosurg (April, 1988: issue
- 68(4)). Pp. 518-531.
-
-