Meningio-angiomatosis in a patient with focal epilepsy: value of PET in diagnoses and preoperative planning of surgery

A 17-year-old boy with epileptic seizures due to meningio-angiomatosis without neurofibromatosis type 2 is presented. Low grade astrocytoma in the left temporal lobe was resected when he was 11 years old. A recurrence was suspected on following-up MRI and a positive PET scan with 11C-methionine PET...

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Bibliographic Details
Published in:Acta neurochirurgica 2003-07, Vol.145 (7), p.587-591
Main Authors: Ohta, Y, Nariai, T, Ishii, K, Ishiwata, K, Senda, M, Okeda, R, Ohno, K, Hirakawa, K
Format: Article
Language:English
Subjects:
Adolescent
Angiomatosis - complications
Angiomatosis - diagnostic imaging
Angiomatosis - surgery
Brain Diseases - complications
Brain Diseases - diagnostic imaging
Brain Diseases - surgery
Child
Clinical Protocols
Convulsions & seizures
Epilepsies, Partial - diagnostic imaging
Epilepsies, Partial - etiology
Epilepsies, Partial - surgery
Epilepsy
Humans
Male
Meninges - diagnostic imaging
Meninges - surgery
Preoperative Care
Reproducibility of Results
Tomography, Emission-Computed
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Summary:A 17-year-old boy with epileptic seizures due to meningio-angiomatosis without neurofibromatosis type 2 is presented. Low grade astrocytoma in the left temporal lobe was resected when he was 11 years old. A recurrence was suspected on following-up MRI and a positive PET scan with 11C-methionine PET 6 years later around the resected area. The language area was mapped using H2(15)O PET activation technique. The lesion was completely resected while preserving the verbal area assisted by three-dimensional imaging protocol of MR-registered PET. The patient was well and seizure-free for 8 years thereafter without antiepileptic drugs. Histologically, there was an increase of dilated arterioles and meningothelial cell-like spindle cells around them, which are characteristic pathological features of meningio-angiomatosis. It is most likely that angiomatous tissue developed perivascular meningiomatous components and formed the meningio-angiomatosis in our presented case. In addition, we presented our protocol of functional neuro-imaging which was useful in terms of the functional neurosurgery.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-003-0047-9