Three Cases of Intracranial Vascular Malformations in Infants

This paper is concerned with intracranial vascular malformations of hamartomatous origin and not with the relatively common aneurysmal, focal, intramural defects of the vessels of the brain.Such hamartomatous lesions have been well described (Cushing and Bailey, 1928; Lindau, 1931; Russell, 1931).They can be classified into three main types, namely (a) haemangioblastomas, (b) cavernous angiomas, and (c) racemose angiomas.Haemangioblastomas usually occur within the cerebellum and often form a cyst with only a small nodule of tumour in its wall.They present as cerebellar tumours and may be associated with similar lesions in the retina and with cysts of the pancreas, kidney, or liver (Lindau's disease).Cavernous angiomas are usually situated within the substance of the brain and are similar in structure to the common cutaneous haemangiomas; occasionally they are associated with angiomatous lesions of the skin and other organs.The third variety is characterized by a mass of recognizable blood vessels in the pia arachnoid.These are variously named racemose angioma, cirsoid aneurysm, angioma venosum, angioma arteriale, or telangiectasis, depending largely upon the appearances at operation or necropsy.The three cases described in this communication had lesions of this third variety.Case Reports Case 1.-A baby girl was born at term and thrived for 42 hours.She then fed poorly and became restless with grunting respirations and rib recession.On the third day she developed cardiac failure.She was given digitalis but died when only 4 days old.Necropsy Findings.-Thebody was that of a female baby with extremely livid skin and intense cyanosis of the lips and nail beds.The heart (41 g.) was almost twice the normal weight and both ventricles were dilated and hypertrophied.The common and internal carotid arteries were widened and thick walled.The caval veins and their tributaries were engorged and the lungs, liver, and