Sami Hussein

De novo development of a cavernous malformation of the brain: Significance of factors with paracrine and endocrine activity: Case report

OBJECTIVE AND IMPORTANCE De novo development of cavernous malformations is poorly documented in the literature. CLINICAL PRESENTATION We report the case of a 37-year old woman with de novo growth of a cavernous malformation of the brain. The patient presented with a 12-month history of nonspecific headaches and paresthesias after two pregnancies. After computed tomographic scanning of the cranium, a cavernous malformation located parieto-occipitally within the right brain hemisphere was diagnosed. Control magnetic resonance imaging scans obtained 12 years earlier did not reveal a similar lesion. INTERVENTION Surgery was performed, and the specimen was analyzed histopathologically. CONCLUSION Immunohistochemistry demonstrated lack of expression of pituitary hormones as well as of androgen, estrogen, and progesterone hormone receptors. However, strong expression of both basic fibroblast growth factor and CD44 was detected in surrounding tissue, and expression of CD44 was noted within the matrix of the cavernous malformation.

The anterior inferior cerebellar artery (AICA): Clinical and radiological significance

It is well known that the anterior inferior cerebellar artery (AICA) is difficult to visualize radiologically. As the analysis of 50 clinical cases shows, although the main branches of the AICA at the level of the basilar artery can be analyzed angiographically, the peripheral course is only vaguely visible. We examined 26 brains (post-mortem) after selective resin-injection and preparation under an operation-microscope. Our results: 1. There is a reciprocal relationship between the development of the AICA and the PICA. 2. We can draw no conclusions concerning the pattern of the AICA of one side to the pattern on the other side. 3. The size of the AICA at the level of the basilar artery gives an indirect indication of the peripheral course. 4. The AICA and the cranial nerves are in a constant relationship to each other.Consideration of these relationships can help in the interpretation of angiograms done before microsurgical operations in the area of the cerebello-pontine angle.