Cerebellar venous angiomas. A continuing controversy
J. Biller, G. J. Toffol, J. F. Shea, M. Fine and B. Azar-Kia
We have studied three patients with angiographically documented cerebellar
venous angioma (CVA). One patient had a subacute cerebellar hematoma and
underwent posterior fossa craniotomy for evacuation of the hematoma and
excision of the malformation. A hemorrhagic venous infarction of the brain
stem and cerebellum occurred, and the patient died three weeks
postoperatively. A second patient with an unruptured CVA had a history of
headaches, tinnitus, and vertigo. Conservative treatment was elected, and
the patient's condition remains unchanged after 11 months of follow-up. The
third patient, recently diagnosed as having an unruptured CVA had episodic
vertigo and disequilibrium. Conservative treatment was chosen, and he is
asymptomatic after six months of follow-up. Based on a review of 24 other
cases of CVA plus our experience we could not conclude any definite trend
regarding natural history or treatment. However, conservative treatment
seems the logical choice in patients with unruptured CVA.
