Yasuichi Ueda

Angiographically occult angiomas: a report of thirteen cases with analysis of the cases documented in the literature

Thirteen cases of angiographically occult angioma (AOA) are reported. Nine of these presented with intraparenchymatous hemorrhage, and the other 4 patients had epilepsy. The pathological diagnosis was arteriovenous malformation in 12 cases and cavernous angioma in 1. All surgical specimens but 2 contained hemosiderin pigment. In addition to these 13 cases, we reviewed 159 cases of AOA reported in the literature and analyzed them in terms of age, sex, symptoms and signs at admission, computed tomographic findings, location and size of angioma, history of previous and recurrent hemorrhage, type of hemorrhage, and outcome of operation to determine the characteristics of AOAs. The results of these analyses are described in detail, and the indications for surgical treatment of suspected AOAs are discussed. Our microsurgical technique for detecting the angioma within or adjacent to the hematoma is also presented.

Subarachnoid hemorrhage in children.

45 cases of subarachnoid hemorrhage in children were surveyed. 73 percent of the causes were arteriovenous malformations and spontaneous intracerebral hematomata. Arteriovenous malformations in children may grow in size which may be due to the fact that besides the nidus demonstrated by angiography there are surrounding abnormal vascular groups, the reserved nidus. If one fails to extirpate this reserve nidus at the time of surgical excision of the arteriovenous malformation, it may become nidus several years later and may bleed again. The follow-up results of surgery in subarachnoid hemorrhage cases were fairly good.