A worried wife

[tweetywillo]

My husband has cerebral palsy and a venous angioma.Can this take is life?

[mommyofnathan]

I am happy to address the questions that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a substitute for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

To start off, one important detail to clarify is exactly what is meant by “venous angioma.”  Technically speaking, venous angiomas are anatomic variants in the brain’s venous system.  In the vast majority of cases, the venous pathways are separated by normal brain tissue and despite the abnormal appearance, these veins behave similar to normal veins from a physiologic perspective.  This distinction is important to recognize as other vascular malformations- cavernous malformations, arteriovenous malformations (AVM’s), and capillary telangiectasias- do not have normal physiologic responses and are thus more prone to complications such as bleeding and “venous strokes.”  Isolated venous angiomas are in the grand scheme of things, often benign and may only be recognized incidentally on brain imaging done for some other reason.  Complications of venous angiomas are rare but include bleeding and thrombosis (i.e. clotting).  There have been  some reports of seizure in isolated cases, however to date, there is no firm data associating seizure with venous angioma. On the other hand, AVM’s have well-documented associations with hemorrhage, seizure, and stroke and thus pose a more imminent threat.

One must realize that while venous angiomas are very often benign, as many as 30% of patients have associated AVM’s, cavernous malformations, or capillary telangiectasias, all of which carry a higher morbidity/mortality.  Although venous angiomas are readily identified on MRI, some of the smaller vascular malformations may be difficult to identify on run-of-the-mill MRI sequences and more sensitive testing such as CT angiography or conventional angiogram may be required.  In general, a venous angioma alone may not be a good indication for surgery based on low morbidity, whereas venous angioma in association with some other type of vascular malformation may warrant surgical treatment.

Because of your symptoms which include seizure, headache, dizziness, and nausea, I would urge you to at least see a neurologist (if not able to see a neurosurgeon) who can review the details of your case and could better determine the acuity of your situation.  If your neurologist identifies any “red flags,” he or she may be able to pull some strings to get you in to see a neurosurgeon much sooner.  Thank you very much for your questions; although it is difficult for me to give you concrete answers without having seen you in clinic, I hope that I have at least provided you with some useful information.

THE ABOVE WAS POSTED BY CCFNEUROMD ON THE NEUROLOGY FORUM. HOPE IT HELPS.