Cerebral venous angioma as a focal epileptogenic lesion

In a 13 year-old boy suffering with uncontrollable adversive seizures to the left side, CT before contrast enhancement did not demonstrate any findings, but a slight atrophic area localized in the right frontal lobe. After contrast enhancement, a tiny linear high density area was seen in the subcortex of the right frontal lobe. Right common carotid angiography demonstrated no abnormalities in the arterial and capillary phases. However in the venous phase, a caput medusae like or cone shaped lesion was found in the white matter of the right frontal lobe and it consisted of nemerous small veins. Right frontal craniotomy was performed. Postoperatively, the patient was uneventful and discharged without any neurological deficits. Adversive seizures disappeared and EEG had normalized. Histological examinations of the specimen revealed that these malformations consisted of small numerous veins separated by neural tissue and as a cerebral venous angioma was diagnosed. (J.P.N.)