transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2024-11-2-216-222NZCGGStransmed-875Research ArticleНЕВРОЛОГИЯ И НЕЙРОХИРУРГИЯNEUROLOGY AND NEUROSURGERYВнутримозговое кровоизлияние вследствие разрыва венозной ангиомы головного мозга (клинический случай и обзор литературы)Intracerebral hemorrhage due to rupture of venous angioma of the brain (case report and literature review)ШнякинП. Г.ShnyakinP. G.

Шнякин Павел Геннадьевич - д.м.н., профессор, заведующий кафедрой травматологии, ортопедии и нейрохирургии с курсом ПО, ФГБОУ ВО КрасГМУ им. проф. В.Ф. Войно-Ясенецкого Минздрава России; врач-нейрохирург КГБУЗ «Краевая клиническая больница»; руководитель краевого регионального сосудистого центра.

Красноярск

Pavel G. Shnyakin - Doctor of Medical Sciences, Professor, Head of the Department of Traumatology, Orthopedics and Neurosurgery with a software course, Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Neurosurgeon, Regional Clinical Hospital; Head of the regional regional vascular center.

Krasnoyarsk

https://orcid.org/0000-0002-3275-614XМилехинаИ. Е.MilekhinaI. E.

Милехина Илона Евгеньевна - к.м.н., доцент, завуч кафедры травматологии, ортопедии и нейрохирургии с курсом ПО, ФГБОУ ВО КрасГМУ им. проф. В.Ф. Войно-Ясенецкого Минздрава России; врач-нейрохирург КГБУЗ «Краевая клиническая больница».

ул. Партизана Железняка, зд. 1, Красноярск, 660022

Ilona E. Milekhina - Candidate of Medical Sciences, Associate Professor, Head of the Department of Traumatology, Orthopedics and Neurosurgery with a software course, Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Neurosurgeon, Regional Clinical Hospital.

Partizana Zheleznyaka str., 1, Krasnoyarsk, 660022

eie-89@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Красноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого» Министерства здравоохранения Российской Федерации; Краевое государственное бюджетное учреждение здравоохранения «Краевая клиническая больница»РоссияKrasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical HospitalRussian Federation202420062024112216222Copyright © Шнякин П.Г., Милехина И.Е., 20242024Шнякин П.Г., Милехина И.Е.Shnyakin P.G., Milekhina I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/875

Венозные ангиомы головного мозга являются одной из самых частых цереброваскулярных аномалий и нередко обнаруживаются при нейровизуализации у людей с неспецифическими жалобами. Принято считать, что венозные ангиомы имеют доброкачественное течение и не нуждаются в наблюдении и лечении. При этом описаны случаи спонтанного тромбоза венозных ангиом с развитием ишемического инсульта и возможного их участия в вазоневральном конфликте и эпилептогенезе. Наибольшее количество публикаций касаются разрывов венозных ангиом с формированием внутримозговых гематом. В статье представлено собственное клиническое наблюдение молодого пациента с внутримозговым кровоизлиянием вследствие разрыва крупной венозной ангиомы, потребовавшим хирургического лечения. Также представлен обзор научных публикаций по частоте кровоизлияний из венозных ангиом, факторам риска и тактике ведения таких пациентов.

Venous cerebral angiomas are one of the most common cerebrovascular anomalies and are often detected by neuroimaging in people with nonspecific complaints. It is generally accepted that venous angiomas have a benign course and do not require observation and treatment. At the same time, cases of spontaneous thrombosis of venous angiomas with the development of ischemic stroke are described, their possible participation in vasoneural conflict and epileptogenesis. The largest number of publications concern ruptures of venous angiomas with the formation of intracerebral hematomas. The article presents our own clinical observation of a young patient with intracerebral hemorrhage due to the rupture of a large venous angioma, which required surgical treatment. A review of scientific publications on the frequency of hemorrhages from venous angiomas, risk factors and management of such patients is also presented.

венозная ангиомавенозная аномалия развитиягеморрагический инсультhemorrhagic strokevenous angiomavenous malformationReferencesШнякин П.Г., Руденко П.Г., Ботов А.В. и др. Опыт ведения пациентов с бактериальными церебральными аневризмами на фоне инфекционного эндокардита//Сибирское медицинское обозрение = Siberian Medical Review. 2023. № 3. С. 100–106. DOI: 10.20333/25000136-2023-3-100-106.Шнякин П.Г., Руденко П.Г., Ботов А.В. и др. Опыт ведения пациентов с бактериальными церебральными аневризмами на фоне инфекционного эндокардита//Сибирское медицинское обозрение = Siberian Medical Review. 2023. № 3. С. 100–106. DOI: 10.20333/25000136-2023-3-100-106.Triquenot-Bagan A, Lebas A, Ozkul-Wermester O, et al. Brain developmental venous anomaly thrombosis. Acta Neurol Belg. 2017; 117(1):315–316. DOI: 10.1007/s13760-016-0707-1.Triquenot-Bagan A, Lebas A, Ozkul-Wermester O, et al. Brain developmental venous anomaly thrombosis. Acta Neurol Belg. 2017; 117(1):315–316. DOI: 10.1007/s13760-016-0707-1.Mooney MA, Zabramski JM. Developmental venous anomalies. Handb Clin Neurol. 2017; 143:279–282. DOI: 10.1016/B978-0-444-63640-9.00026-6.Mooney MA, Zabramski JM. Developmental venous anomalies. Handb Clin Neurol. 2017; 143:279–282. DOI: 10.1016/B978-0-444-63640-9.00026-6.Aoki R, Srivatanakul K. Developmental venous anomaly: benign or not benign. Neurol Med Chir (Tokyo). 2016; 56(9):534–543. DOI: 10.2176/nmc.ra.2016-0030.Aoki R, Srivatanakul K. Developmental venous anomaly: benign or not benign. Neurol Med Chir (Tokyo). 2016; 56(9):534–543. DOI: 10.2176/nmc.ra.2016-0030.Ruíz DS, Yilmaz H, Gailloud P. Cerebral developmental venous anomalies: current concepts. Ann Neurol. 2009; 66(3):271–283. DOI: 10.1002/ana.21754.Ruíz DS, Yilmaz H, Gailloud P. Cerebral developmental venous anomalies: current concepts. Ann Neurol. 2009; 66(3):271–283. DOI: 10.1002/ana.21754.Pereira VM, Geibprasert S, Krings T, et al. Pathomechanisms of symptomatic developmental venous anomalies. Stroke. 2008; 39(12):3201–3215. DOI:10.1161/STROKEAHA.108.521799.Pereira VM, Geibprasert S, Krings T, et al. Pathomechanisms of symptomatic developmental venous anomalies. Stroke. 2008; 39(12):3201–3215. DOI:10.1161/STROKEAHA.108.521799.Abe M, Hagihara N, Tabuchi K, et al. Histologically classified venous angiomas of the brain: a controversy. Neurol Med Chir (Tokyo). 2003; 43(1):1–10. DOI: 10.2176/nmc.43.1.Abe M, Hagihara N, Tabuchi K, et al. Histologically classified venous angiomas of the brain: a controversy. Neurol Med Chir (Tokyo). 2003; 43(1):1–10. DOI: 10.2176/nmc.43.1.Lasjaunias P, Burrows P, Planet C. Developmental venous anomalies (DVA): the so-called venous angioma. Neurosurg Rev. 1986; 9(3):233–242. DOI: 10.1007/bf01743138.Lasjaunias P, Burrows P, Planet C. Developmental venous anomalies (DVA): the so-called venous angioma. Neurosurg Rev. 1986; 9(3):233–242. DOI: 10.1007/bf01743138.Garner TB, Del Curling O Jr, Kelly DL Jr, et al. The natural history of intracranial venous angiomas. J Neurosurg. 1991; 75:715–722. DOI: 10.3171/jns.1991.75.5.0715.Garner TB, Del Curling O Jr, Kelly DL Jr, et al. The natural history of intracranial venous angiomas. J Neurosurg. 1991; 75:715–722. DOI: 10.3171/jns.1991.75.5.0715.Yu XG, Wu C, Zhang H, et al. The management of symptomatic cerebral developmental venous anomalies: a clinical experience of 43 cases. Med Sci Monit. 2016; 22:4198–4204. DOI: 10.12659/msm.898199.Yu XG, Wu C, Zhang H, et al. The management of symptomatic cerebral developmental venous anomalies: a clinical experience of 43 cases. Med Sci Monit. 2016; 22:4198–4204. DOI: 10.12659/msm.898199.Kiroglu Y, Oran I, Dalbasti T, et al. Thrombosis of a drainage vein in developmental venous anomaly (DVA) leading venous infarction: a case report and review of the literature. J Neuroimaging. 2011; 21(2):197–201. DOI: 10.1111/j.1552-6569.2009.00399.x.Kiroglu Y, Oran I, Dalbasti T, et al. Thrombosis of a drainage vein in developmental venous anomaly (DVA) leading venous infarction: a case report and review of the literature. J Neuroimaging. 2011; 21(2):197–201. DOI: 10.1111/j.1552-6569.2009.00399.x.Agarwal А, Kanekar S, Kalapos P, et al. Spontaneous thrombosis of developmental venous anomaly (DVA) with venous infarct and acute cerebellar ataxia. Emerg Radiol. 2014; 21(4):427–430. DOI: 10.1007/s10140-014-1216-2.Agarwal А, Kanekar S, Kalapos P, et al. Spontaneous thrombosis of developmental venous anomaly (DVA) with venous infarct and acute cerebellar ataxia. Emerg Radiol. 2014; 21(4):427–430. DOI: 10.1007/s10140-014-1216-2.Egorova EV, Dmitrienko DV. Developmental venous anomalies and epilepsy. Doctor.Ru. 2021; 20(9):21–25. In Russian [Егорова Е.В., Дмитренко Д.В. Венозные аномалии развития и эпилепсия. Доктор.Ру. 2021; 20(9):21–25]. DOI: 10.31550/1727-2378-2021-20-9-21-25.Egorova EV, Dmitrienko DV. Developmental venous anomalies and epilepsy. Doctor.Ru. 2021; 20(9):21–25. In Russian [Егорова Е.В., Дмитренко Д.В. Венозные аномалии развития и эпилепсия. Доктор.Ру. 2021; 20(9):21–25]. DOI: 10.31550/1727-2378-2021-20-9-21-25.Gümüs A, Yildirim SV, Kizilkiliç O, et al. Case report: seizures in a child caused by a large venous angioma. J Child Neurol. 2007; 22(6):787–789. DOI: 10.1177/0883073807304056.Gümüs A, Yildirim SV, Kizilkiliç O, et al. Case report: seizures in a child caused by a large venous angioma. J Child Neurol. 2007; 22(6):787–789. DOI: 10.1177/0883073807304056.Ucler N. An intracranial developmental venous anomaly presenting with seizure. Neurol India. 2019; 67(2):604–605. DOI: 10.4103/0028-3886.258034.Ucler N. An intracranial developmental venous anomaly presenting with seizure. Neurol India. 2019; 67(2):604–605. DOI: 10.4103/0028-3886.258034.Mizokami K, Amano T, Inamura T, et al. [Brain stem hemorrhage associated with venous angioma: report of two cases]. No Shinkei Geka. 2001; 29(1):75–79. In Japanese.Mizokami K, Amano T, Inamura T, et al. [Brain stem hemorrhage associated with venous angioma: report of two cases]. No Shinkei Geka. 2001; 29(1):75–79. In Japanese.Pilipenko Y, Konovalov A, Okishev D, et al. Formation during lifetime of arteriovenous shunt in developmental venous anomaly that caused intracerebral hemorrhage. World Neurosurg. 2018; 119:168–171. DOI: 10.1016/j.wneu.2018.07.226.Pilipenko Y, Konovalov A, Okishev D, et al. Formation during lifetime of arteriovenous shunt in developmental venous anomaly that caused intracerebral hemorrhage. World Neurosurg. 2018; 119:168–171. DOI: 10.1016/j.wneu.2018.07.226.Li X, Wang Y, Chen W, et al. Intracerebral hemorrhage due to developmental venous anomalies. J Clin Neurosci. 2016; 26:95–100. DOI: 10.1016/j.jocn.2015.06.031.Li X, Wang Y, Chen W, et al. Intracerebral hemorrhage due to developmental venous anomalies. J Clin Neurosci. 2016; 26:95–100. DOI: 10.1016/j.jocn.2015.06.031.Marzouk O, Marzouk S, Liyanage SH, et al. Cerebellar developmental venous anomaly with associated cavernoma causing a hemorrhage — a rare occurrence. Radiol Case Rep. 2021; 16(6):1463–1468. DOI: 10.1016/j.radcr.2021.03.010.Marzouk O, Marzouk S, Liyanage SH, et al. Cerebellar developmental venous anomaly with associated cavernoma causing a hemorrhage — a rare occurrence. Radiol Case Rep. 2021; 16(6):1463–1468. DOI: 10.1016/j.radcr.2021.03.010.Das KK, Rangari K, Singh S, et al. Coexistent cerebral cavernous malformation and developmental venous anomaly: does an aggressive natural history always call for surgical intervention? Asian J Neurosurg. 2019; 14(1):318–321. DOI: 10.4103/ajns.AJNS_196_18.Das KK, Rangari K, Singh S, et al. Coexistent cerebral cavernous malformation and developmental venous anomaly: does an aggressive natural history always call for surgical intervention? Asian J Neurosurg. 2019; 14(1):318–321. DOI: 10.4103/ajns.AJNS_196_18.Fujimoto T, Kawahara I, Tsutsumi K, et al. [A rare case of developmental venous anomaly with diffuse arteriovenous shunt in the posterior fossa presented as massive cerebellar hemorrhage]. No Shinkei Geka. 2013; 41(7):619–625. In Japanese.Fujimoto T, Kawahara I, Tsutsumi K, et al. [A rare case of developmental venous anomaly with diffuse arteriovenous shunt in the posterior fossa presented as massive cerebellar hemorrhage]. No Shinkei Geka. 2013; 41(7):619–625. In Japanese.Wolf PA, Rosman NP, New PF. Multiple small cryptic venous angiomas of the brain mimicking cerebral metastases. A clinical, pathological, and angiographic study. Neurology. 1967; 17(5):491–501. DOI: 10.1212/wnl.17.5.491.Wolf PA, Rosman NP, New PF. Multiple small cryptic venous angiomas of the brain mimicking cerebral metastases. A clinical, pathological, and angiographic study. Neurology. 1967; 17(5):491–501. DOI: 10.1212/wnl.17.5.491.Amuluru K, Al-Mufti F, Hannaford S, et al. Symptomatic infratentorial thrombosed developmental venous anomaly: case report and review of the literature. Interv Neurol. 2016; 4(3-4):130–137. DOI: 10.1159/000444028.Amuluru K, Al-Mufti F, Hannaford S, et al. Symptomatic infratentorial thrombosed developmental venous anomaly: case report and review of the literature. Interv Neurol. 2016; 4(3-4):130–137. DOI: 10.1159/000444028.Silva AHD, Wijesinghe H, Lo WB, et al. Paediatric developmental venous anomalies (DVAs): how often do they bleed and where? Childs Nerv Syst. 2020; 36(7):1435–1443. DOI: 10.1007/s00381-019-04460-1.Silva AHD, Wijesinghe H, Lo WB, et al. Paediatric developmental venous anomalies (DVAs): how often do they bleed and where? Childs Nerv Syst. 2020; 36(7):1435–1443. DOI: 10.1007/s00381-019-04460-1.Huber G, Henkes H, Hermes M, et al. Regional association of developmental venous anomalies with angiographically occult vascular malformations. Eur Radiol. 1996; 6(1):30–37. DOI: 10.1007/BF00619949.Huber G, Henkes H, Hermes M, et al. Regional association of developmental venous anomalies with angiographically occult vascular malformations. Eur Radiol. 1996; 6(1):30–37. DOI: 10.1007/BF00619949.Taydas O, Ogul H, Kantarci M. An analysis of lesions associated with developmental venous anomalies. Ann R Coll Surg Engl. 2021; 103(10):768–774. DOI: 10.1308/rcsann.2021.0121.Taydas O, Ogul H, Kantarci M. An analysis of lesions associated with developmental venous anomalies. Ann R Coll Surg Engl. 2021; 103(10):768–774. DOI: 10.1308/rcsann.2021.0121.Abdulrauf SI, Kaynar MY, Awad IA. A comparison of the clinical profile of cavernous malformations with and without associated venous malformations. Neurosurgery. 1999; 44(1):41–47. DOI: 10.1097/00006123-199901000-00020.Abdulrauf SI, Kaynar MY, Awad IA. A comparison of the clinical profile of cavernous malformations with and without associated venous malformations. Neurosurgery. 1999; 44(1):41–47. DOI: 10.1097/00006123-199901000-00020.Idiculla PS, Gurala D, Philipose J, et al. Cerebral cavernous malformations, developmental venous anomaly, and its coexistence: a review. Eur Neurol. 2020; 83(4):360–368. DOI: 10.1159/000508748.Idiculla PS, Gurala D, Philipose J, et al. Cerebral cavernous malformations, developmental venous anomaly, and its coexistence: a review. Eur Neurol. 2020; 83(4):360–368. DOI: 10.1159/000508748.Tomycz ND, Vora NA, Kanal E, et al. Intracranial arterialized venous angioma: case report with new insights from functional brain MRI. Diagn Interv Radiol. 2010; 16(1):3–15. DOI: 10.4261/1305-3825.DIR.1627-08.1.Tomycz ND, Vora NA, Kanal E, et al. Intracranial arterialized venous angioma: case report with new insights from functional brain MRI. Diagn Interv Radiol. 2010; 16(1):3–15. DOI: 10.4261/1305-3825.DIR.1627-08.1.Agazzi S, Regli L, Uske A, et al. Developmental venous anomaly with an arteriovenous shunt and a thrombotic complication. Case report. J Neurosurg. 2001; 94(3):533–537. DOI: 10.3171/jns.2001.94.3.0533.Agazzi S, Regli L, Uske A, et al. Developmental venous anomaly with an arteriovenous shunt and a thrombotic complication. Case report. J Neurosurg. 2001; 94(3):533–537. DOI: 10.3171/jns.2001.94.3.0533.Im SH, Han MH, Kwon BJ, et al. Venous-predominant parenchymal arteriovenous malformation: a rare subtype with a venous drainage pattern mimicking developmental venous anomaly. J Neurosurg. 2008; 108(6):1142–1147. DOI: 10.3171/JNS/2008/108/6/1142.Im SH, Han MH, Kwon BJ, et al. Venous-predominant parenchymal arteriovenous malformation: a rare subtype with a venous drainage pattern mimicking developmental venous anomaly. J Neurosurg. 2008; 108(6):1142–1147. DOI: 10.3171/JNS/2008/108/6/1142.

The authors declare that there are no conflicts of interest present.