Rare Diseases Symptoms Automatic Extraction
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[Epidemiology, treatment and follow-up of central nervous system hemangioblastomas in von Hippel-Lindau disease].
[von hippel-lindau disease]
Central
nervous
system
(
CNS
)
hemangioblastomas
(
HGB
)
are
rare
vascular
tumors
.
The
goal
of
this
study
was
to
analyze
their
epidemiology
,
treatment
and
prognosis
in
association
with
von
Hippel-
Lindau
(
VHL
)
disease
.
We
retrospectively
reviewed
a
series
of
patients
treated
in
our
department
for
a
CNS
HGB
with
VHL
disease
between
1996
and
2008
.
We
analyzed
pre-
and
postoperative
clinical
and
radiological
characteristics
,
number
of
visceral
lesions
(
fundoscopy
,
abdomino-pelvian
CT
,
metanephrines
)
,
clinical
course
(
modified
Rankin
Scale
and
McCormick
scale
)
and
late
prognosis
(
Kaplan-
Meier
survival
curves
)
.
We
studied
19
cases
(
sex-ratio
0
.
9
,
mean
age
36
)
.
The
mean
time
to
diagnosis
was
61
days
.
The
main
symptom
was
intracranial
hypertension
for
cerebellar
lesions
(
7
/
15
)
and
a
sensitive-
motor
deficit
for
medulla
oblongata
(
2
/
5
)
or
spinal
lesions
(
5
/
11
)
.
Preferred
locations
were
cerebellum
(
15
/
31
)
,
often
nodulo-
cystic
appearance
,
followed
by
spinal
cord
(
11
/
31
)
,
frequently
coming
with
adjacent
syringomyelia
.
Multiple
locations
and
visceral
lesions
were
found
in
two
-
third
of
the
cases
.
Surgical
removal
was
complete
in
more
than
three
-
quarter
of
the
cases
.
Mean
follow-up
duration
was
9
years
.
Postoperative
mortality
rate
was
16
%
.
In
cerebellar
and
medulla
oblongata
locations
together
,
final
mRS
was
≤
1
in
17
of
the
20
cases
.
In
spinal
cord
locations
,
final
McCormick
score
was
≤
2
in
all
the
cases
.
After
delayed
follow-up
,
about
two
-
third
of
patients
experienced
recurrence
or
new
progressive
CNS
lesions
.
HGB
are
rare
CNS
tumors
.
VHL
disease
should
be
considered
when
an
HGB
is
diagnosed
before
30
,
is
located
at
the
spinal
cord
,
comes
with
multiple
other
CNS
lesions
or
with
typical
peripheral
lesions
.
Microsurgical
removal
is
the
gold
standard
treatment
and
can
offer
good
functional
results
.
Diseases
Validation
Diseases presenting
"syringomyelia"
symptom
achondroplasia
acute rheumatic fever
proteus syndrome
triple a syndrome
von hippel-lindau disease
This symptom has already been validated