Document Detail


Cerebral cavernous malformations with dynamic and progressive course: correlation study with vascular endothelial growth factor.
MedLine Citation:
PMID:  14623736     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cerebral cavernous malformations (CCMs) are reported to exhibit a wide range of dynamic patterns including growth, regression, and de novo formation, which generally show slow and steady courses. Although the pathogenesis of CCMs is not well known, vascular endothelial growth factor (VEGF) has been suggested as a possible mediating factor. OBJECTIVES: To report CCMs showing rapid progression over a short period and to investigate these biological characteristics. DESIGN: Experimental study. SETTING: Tertiary referral center, neurology department. Patient A 40-year-old man was admitted because of a left-sided numbness, vertigo, and ataxia, which were attributed to a pontine hemorrhage. He had experienced a left-sided weakness 6 months before admission, and thereafter had complained of intermittent headache. Serial brain magnetic resonance images showed multiple intracerebral microhemorrhages throughout the cerebral hemispheres. A biopsy of the lesion confirmed the diagnosis of CCM. MAIN OUTCOME MEASURES: We investigated the expression of VEGF by immunohistochemistry of the biopsy specimen. Dynamic patterns of CCMs, obtained with spin-echo magnetic resonance images with gradient-echo sequences, were compared with serial serum VEGF concentrations, determined by enzyme-linked immunosorbent assay. RESULTS: Immunohistochemistry of the specimen displayed increased VEGF expression. Serial magnetic resonance images during 7 months showed dynamic signal changes of the preexisting lesions and 15 de novo formations in many cortices. The VEGF level in serum increased during this dynamic period and became normal during the steady and resolving stages. CONCLUSIONS: Cerebral cavernous malformations can be progressively deteriorating. The endothelial proliferation induced by VEGF is likely to be an important aspect of the pathogenetic mechanisms of CCMs.
Authors:
Keun-Hwa Jung; Kon Chu; Sang-Wuk Jeong; Hee-Kwon Park; Hee-Joon Bae; Byung-Woo Yoon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of neurology     Volume:  60     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-18     Completed Date:  2003-12-10     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1613-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology and Clinical Research Institute, Seoul National University Hospital, Seoul, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cerebral Hemorrhage / etiology,  pathology
Disease Progression
Enzyme-Linked Immunosorbent Assay
Frontal Lobe / metabolism,  pathology*
Hemangioma, Cavernous, Central Nervous System / complications,  metabolism*,  pathology*
Humans
Immunohistochemistry
Magnetic Resonance Imaging
Male
Vascular Endothelial Growth Factor A / blood,  metabolism*
Chemical
Reg. No./Substance:
0/Vascular Endothelial Growth Factor A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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