8
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Meningoangiomatosis: a propósito de un caso. Revisión de hallazgos en neuroimagen Translated title: Meningoangiomatosis: about a case review of findings in neuroimaging

      case-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen La meningoangiomatosis es una lesión intracraneal benigna y poco frecuente, que afecta fundamentalmente a las leptomeninges y a la corteza cerebral subyacente, siendo más frecuente en niños y adultos jóvenes. Aunque la mayoría de casos se presentan de forma aislada, se ha descrito su asociación con síndromes como la neurofibromatosis tipo 2, estos últimos más frecuentemente asintomáticos y con buena respuesta farmacológica; sin embargo, las presentaciones esporádicas presentan un amplio espectro clínico, abarcando desde cefaleas crónicas hasta crisis convulsivas refractarias, llegando incluso a asociarse a lesiones intracraneales como los meningiomas. En este artículo presentamos nuestra experiencia con una paciente joven que debutó con un episodio de crisis epiléptica focal motora con evolución tónico-clónica generalizada y buena respuesta al tratamiento antiepiléptico. Dada la alta inespecificidad asociada a esta patología, tanto clínica como radiológica, nuestro objetivo es sintetizar los hallazgos radiológicos que nos permiten el planteamiento diagnóstico de esta entidad en pacientes clínicamente compatibles.

          Translated abstract

          Abstract Meningoangiomatosis is a rare and benign intracranial affectation, affecting mainly leptomeninges and the underlying cerebral cortex, being more frequent in children and young adults. Although most of the cases are presented in an isolated way, it has been described its association with syndromes such as neurofibromatosis type 2, these last ones more frequently asymptomatic and with good pharmacological response; however, the sporadic presentations present a wide clinical spectrum, ranging from chronic headaches to refractory convulsive crisis, even being associated to intracranial lesions such as meningiomas. In this article we present our experience with a young patient who debuted with an episode of focal motor epileptic seizure with generalized tonic-clonic evolution and good response to antiepileptic treatment. Given the high unspecificity associated with this pathology, both clinical and radiological, our aim is to synthesize the radiological findings that allow us the diagnostic approach of this entity in clinically compatible patients.

          Related collections

          Most cited references8

          • Record: found
          • Abstract: found
          • Article: not found

          Meningioangiomatosis. A comprehensive analysis of clinical and laboratory features.

          Meningioangiomatosis (MA) is a rare, benign, focal lesion of the leptomeninges and underlying cerebral cortex characterized by leptomeningeal and meningovascular proliferation. It may occur sporadically or in association with neurofibromatosis type 2. Previous reports have emphasized histological and imaging features. Data on the management of these patients are sparse, and electrophysiological features of MA lesions have not been published. We assessed the clinical, electrophysiological, histopathological and imaging features as well as the surgical outcome in MA, and compared MA with and without neurofibromatosis. Seven patients with MA at our centre were investigated and their outcome was assessed. A review of the literature is included. MA exhibits a wide range of clinical, imaging, histopathological and electrophysiological features, making the diagnosis difficult. Sporadic MA cases are not associated with neurofibromatosis and the two disorders are genetically distinct. Medically refractory, localization-related epilepsy is the commonest presentation in sporadic cases, but atypical presentations also occur. Unlike sporadic cases, MA with neurofibromatosis is often found incidentally, does not produce seizures, occurs less frequently (ratio of 1:4), and is multifocal. MRI findings in MA correspond to the histological picture. However, the appearance on imaging is non-specific and may suggest cystic atrophy, angioma and tumours. Several abnormalities have been found in close proximity to MA lesions, i.e. meningioma, oligodendroglioma, arteriovenous malformation, encephalocoel and orbital erosion. In spite of histopathological diversity, MA lesions are either predominantly cellular or vascular. Immunohistochemical results are inconsistent among cases, add little to the diagnosis, and do not support a meningeal origin. Electrocorticographic recordings from the surface and within MA lesions revealed a spectrum of electrophysiological expressions. Intrinsic epileptogenicity of MA lesions was documented in some cases. Epileptogenicity was confined to the perilesional cortex in some patients and it was complex (extralesional, multifocal, generalized) in others. Only 43% of our patients became seizure-free postoperatively compared with 68% previously reported, and >70% of our patients and those in the literature continued to require antiepileptic drugs. This is in keeping with the diverse electrophysiology of MA and suggests a less optimistic postoperative outcome than previously recognized.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Histopathological study of five cases with sporadic meningioangiomatosis.

            We report five cases of sporadic meningioangiomatosis, three males and two females, ranging in age from 12 to 36 years at diagnosis. The lesion was found incidentally by MRI after a head trauma in one case; the other four subjects had a seizure disorders, which improved following surgical resection of the cortical lesions. Grossly, the lesionectomy specimens were of a whitish color and firm consistency. Histological examination revealed that the lesions were confined to the cortex with focal involvement of the overlying leptomeninges, and revealed unifying features of meningioangiomatosis, such as proliferating microvessels with perivascular cuffs of spindle-cell proliferation within the cortex. Two cases had numerous calcifications; one was associated with a prominent fibrocalcifying component. Immunostaining results were variable among the cases. Only vimentin was consistently positive. Some of the spindle cells were weak positive for EMA in two cases. Immunoreactions with anti-CD34 detected within the cytoplasm of the spindle cells were observed in three of the five cases. The Ki-67 proliferation index of all the cases was very low, less than 0.1%. Neurofibrillary tangles were identified in only one of the five cases using the Bodian and immunostaining methods. These findings indicate that meningioangiomatosis lesions show a wide range of clinicopathological features, making diagnosis difficult. A histopathological spectrum and differential diagnoses were discussed with a review of the literature. Since this lesion is a distinct clinicopathological entity and hamartomatous in nature, it is important to make a correct diagnosis in order to avoid further aggressive treatment.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Meningioangiomatosis: A Case Report and Literature Review Emphasizing Diverse Appearance on Different Imaging Modalities

              Purpose. Meningioangiomatosis (MA) is a rare, benign lesion that commonly mimics other intracranial malformations in clinical presentation and appearance on imaging. The case presented and the literature review performed highlight the importance of combining MRI and CT results to better characterize intracranial lesions and including MA on the list of differential diagnoses of patients presenting with seizures. Methods. The case described is of a 19-year-old male with a 10-year history of worsening seizures refractory to multiple drug regimens. MRI revealed an atypical vascular malformation. The patient underwent surgical resection of the epileptogenic cortex. Results. Although the radiologic impression of the lesion was a vascular malformation, pathological examination revealed MA. A literature search performed highlights the variability of the appearance of MA on CT and MRI and suggests the utility of the T2 GRE sequence in illustrating the presence of calcification and, in a lesion with other characteristic features, the diagnosis of MA. Conclusion. MA can be a difficult diagnosis to make based on imaging findings alone. However, in a patient with a characteristic history and presentation, the presence of a calcified mass on CT and MRI brain susceptibility artifact on a T2 GRE sequence may suggest MA.
                Bookmark

                Author and article information

                Journal
                jonnpr
                Journal of Negative and No Positive Results
                JONNPR
                Research and Science S.L. (Madrid, Madrid, Spain )
                2529-850X
                2021
                : 6
                : 10
                : 1279-1288
                Affiliations
                [2] orgnameHospital General Universitario de Albacete orgdiv1Servicio de Neurología España
                [1] orgnameHospital General Universitario de Albacete orgdiv1Servicio de Radiodiagnóstico España
                Article
                S2529-850X2021001001279 S2529-850X(21)00601001279
                10.19230/jonnpr.4174
                40b6d3e8-ed4d-4d3e-a0ec-7bd60b0162f6

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 18 December 2020
                : 12 April 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 10
                Product

                SciELO Spain

                Categories
                Original

                Seizure Crisis,Meningioangiomatosis,Magnetic Resonance Imaging,Leptomeningeal Angiomatosis,Angiografía,Tomografía Computerizada,Angiomatosis Leptomeníngea,Resonancia Magnética,Crisis Convulsivas,Angiography,Computed Tomography

                Comments

                Comment on this article