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Cerebral capillary telangiectasias: a meta-analysis and review of the literature.
MedLine Citation:
PMID:  23192650     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
As a result of their presumed benign natural history, cerebral capillary telangiectasias (CCTs) are infrequently addressed in the neurosurgical literature. We performed a comprehensive review of CCTs via the PubMed database to synthesize overall epidemiological, radiographic, natural history, and treatment results. Across ten series with 203 patients, mean age was 47, and 45 % were male [95 % confidence interval (CI), 0.30-0.65]. Notably, 78 % of CCTs were in the pons (95 % CI, 0.58-1.0). Six percent of CCTs were symptomatic. Across five radiographic series, all lesions enhanced after gadolinium, and all were hypointense on gradient echo sequences. Thirty-three percent were hypointense on T1-weighted pre-contrast imaging (95 % CI, 0.2-0.51), 49 % were hyperintense on T2-weighted imaging (95 % CI, 0.31-0.72), and 74 % were hypointense on diffusion-weighted imaging (95 % CI, 0.5-1.0). Notably, 37 % were associated with a prominent draining vein (95 % CI, 0.21-0.6), and 11 % with a developmental venous anomaly (95 % CI, 0.04-0.25). Across four observational studies with 47 patients, there was no observed change in lesion morphology or hemorrhage in 65.7 patient-years of follow-up. Although the vast majority of CCTs are managed conservatively, we found ten cases of patients treated with surgical excision. We confirm that CCTs are a benevolent entity with a predilection for the pons. They have distinctive radiographic features including their lack of mass effect, consistent enhancement on T1-weighted sequences and hypointensity on gradient echo sequences, and common isointensity on pre-contrast T1-weighted and T2-weighted images. Management for these lesions has been nonoperative in almost all cases.
Authors:
Bradley A Gross; Ajit S Puri; A John Popp; Rose Du
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-29
Journal Detail:
Title:  Neurosurgical review     Volume:  -     ISSN:  1437-2320     ISO Abbreviation:  Neurosurg Rev     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908181     Medline TA:  Neurosurg Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurological Surgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
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