title: Symptomatic large or giant capillary telangiectasias: management and outcome in 5 cases.
abstract: Brain capillary telangiectasias (BCTs) are usually small and benign with a predilection in the pons and basal ganglion. Reports of large and symptomatic BCTs are rare. Large BCTs have a much higher risk of causing uncontrolled bleeding and severe neurological defects, and they can be fatal if left untreated. Therefore, large BCTs should be managed with special caution. Because of the lack of reports, diagnosis of large BCTs has been difficult. Strategies of management are undefined for large or giant BCTs. The current study presents 5 cases of giant and large BCTs. To the authors' knowledge, this is the largest series of this disease ever reported. Radiological findings, histopathological characteristics, clinical presentations, and surgical management were analyzed in 5 symptomatic, unusually large BCTs (mean diameter 5.06 cm, range 1.8-8 cm). Four patients presented with focal or generalized seizures, and 1 patient presented with transient vision loss attributed to the lesions. Gross-total resection of the lesion was achieved in all patients. After surgery, the 4 patients with seizures were symptom free for follow-up periods varying from more than 1 to 5 years with no additional neurological deficits. The unique location, radiological characteristics, and clinical course suggest that giant BCTs could be a different entity from small BCTs. Surgery might be a good option for treatment of patients with intractable neurological symptoms, especially in those with surgically accessible locations. Complete removal would be anticipated to provide relief of the symptoms without causing new neurological deficits.
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Xingwen
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital; and.
authors.forename: Yan
authors.initials: Y
authors.lastname: You
authors.affiliation: Department of Pathology, Peking Union Medical College Hospital; and.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Pathology, Beijing Tiantan Hospital, Capital Medical University;|Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, China;
authors.forename: Jun-Mei
authors.initials: JM
authors.lastname: Wang
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Shuo
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York; and.
authors.forename: Ning
authors.initials: N
authors.lastname: Lin
authors.affiliation: Department of General Surgery, Harlem Hospital, Columbia University Medical Center, New York, New York.
authors.forename: Buqing
authors.initials: B
authors.lastname: Liang
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Jizong
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: BCT = brain capillary telangiectasia; CM = cavernous malformation; DSA = digital subtraction angiography; ECoG = electrocorticography; EEG = electroencephalography; capillary telangiectasia; resection; vascular disorders; vascular malformation