ABSTRACT
Cerebral cavernous malformations (CCMs) are congenital abnormalities of the cerebral vessels. The de novo development of new lesions in this disease has been reported. However, the underlying mechanism of progressive CCMs in such patients remains unclear. This report documents two cases of multiple probable CCMs that showed a progressive behaviour. The plasma levels of vascular endothelial growth factor (VEGF), and transforming growth factor-beta1 (TGF-beta1) were measured using an enzyme-linked immunosorbent assay (ELISA). The concentration of both VEGF and TGF-beta1 in plasma was increased in these patients. A relationship was observed between high concentrations of growth factors and progressive CCMs. Even though a causal linkage between these conditions cannot be confirmed, a continuous high VEGF level in plasma could be a possible clinical indicator for subsequent intracerebral haemorrhages in the CCM patients.
Subject(s)
Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/etiology , Hemangioma, Cavernous, Central Nervous System/blood , Hemangioma, Cavernous, Central Nervous System/complications , Vascular Endothelial Growth Factor A/blood , Biomarkers/analysis , Biomarkers/blood , Causality , Cerebral Arteries/diagnostic imaging , Cerebral Arteries/metabolism , Cerebral Arteries/pathology , Cerebral Hemorrhage/prevention & control , Cerebral Veins/diagnostic imaging , Cerebral Veins/metabolism , Cerebral Veins/pathology , Disease Progression , Enzyme-Linked Immunosorbent Assay , Female , Hemangioma, Cavernous, Central Nervous System/physiopathology , Humans , Male , Middle Aged , Predictive Value of Tests , Radiography , Transforming Growth Factor beta1/analysis , Transforming Growth Factor beta1/blood , Up-Regulation/physiology , Vascular Endothelial Growth Factor A/analysisABSTRACT
Spinal chronic subdural haematomas (SSDH) are extremely rare. We report a case of a SSDH combined with intracranial SDH. After tapping the SSDH in addition to the evacuation of SDH, the clinical symptoms dramatically improved. SSDH are considered to have an uncertain prognosis; however, good results can be obtained with an early diagnosis and prompt treatment.