Vascular malformations of central nervous system: A series from tertiary care hospital in South India.
OBJECTIVE
To describe clinicopathological features of surgically resected vascular malformations (VMs) of central nervous system (CNS).


METHODS
Histologically diagnosed cases of VMs of CNS during April 2010-April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG), Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs) were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma.


RESULTS
Fifty cases were diagnosed as VMs of CNS with an age range of 14-62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36) presented with seizures, whereas AVM patients (8/12) had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas.


CONCLUSIONS
Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage.
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Sudhir Babu
SB
Karri
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Megha S
MS
Uppin
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
A
A
Rajesh
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
K
K
Ashish
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Suchanda
S
Bhattacharjee
Department of Radiology and Imageology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Y Jyotsna
YJ
Rani
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
B P
BP
Sahu
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
M Vijaya
MV
Saradhi
Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
A K
AK
Purohit
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Sundaram
S
Challa
Arteriovenous malformation; cavernoma; hemorrhage; seizures