DOI QR코드

DOI QR Code

Two cases of familial cerebral cavernous malformation caused by mutations in the CCM1 gene

  • Yang, Im-Yong (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan college of Medicine) ;
  • Yum, Mi-Sun (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan college of Medicine) ;
  • Kim, Eun-Hee (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan college of Medicine) ;
  • Choi, Hae-Won (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan college of Medicine) ;
  • Yoo, Han-Wook (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan college of Medicine) ;
  • Ko, Tae-Sung (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan college of Medicine)
  • Received : 2014.07.09
  • Accepted : 2014.08.22
  • Published : 2016.06.15

Abstract

Cerebral cavernous malformation (CCM) is a vascular malformation characterized by abnormally enlarged capillary cavities without any intervening neural tissue. We report 2 cases of familial CCMs diagnosed with the CCM1 mutation by using a genetic assay. A 5-year-old boy presented with headache, vomiting, and seizure-like movements. Brain magnetic resonance imaging (MRI) revealed multiple CCM lesions in the cerebral hemispheres. Subsequent mutation analysis of his father and other family members revealed c.940_943 del (p.Val314 Asn315delinsThrfsX3) mutations of the CCM1 gene. A 10-month-old boy who presented with seizure-like movements was reported to have had no perinatal event. His aunt was diagnosed with cerebral angioma. Brain and spine MRI revealed multiple angiomas in the cerebral hemisphere and thoracic spinal cord. Mutation analysis of his father was normal, although that of the patient and his mother revealed c.535C>T (p.Arg179X) mutations of the CCM1 gene. Based on these studies, we suggest that when a child with a familial history of CCMs exhibits neurological symptoms, the physician should suspect familial CCMs and consider brain imaging or a genetic assay.

Keywords

References

  1. Al-Holou WN, O'Lynnger TM, Pandey AS, Gemmete JJ, Thompson BG, Muraszko KM, et al. Natural history and imaging prevalence of cavernous malformations in children and young adults. J Neurosurg Pediatr 2012;9:198-205. https://doi.org/10.3171/2011.11.PEDS11390
  2. Kivelev J, Niemelä M, Hernesniemi J. Characteristics of cavernomas of the brain and spine. J Clin Neurosci 2012;19:643-8. https://doi.org/10.1016/j.jocn.2011.08.024
  3. Labauge P, Denier C, Bergametti F, Tournier-Lasserve E. Genetics of cavernous angiomas. Lancet Neurol 2007;6:237-44. https://doi.org/10.1016/S1474-4422(07)70053-4
  4. D'Angelo R, Scimone C, Calabro M, Schettino C, Fratta M, Sidoti A. Identification of a novel CCM2 gene mutation in an Italian family with multiple cerebral cavernous malformations and epilepsy: a causative mutation? Gene 2013;519:202-7. https://doi.org/10.1016/j.gene.2012.09.045
  5. Reddy S, Gorin MB, McCannel TA, Tsui I, Straatsma BR. Novel KRIT1/CCM1 mutation in a patient with retinal cavernous hemangioma and cerebral cavernous malformation. Graefes Arch Clin Exp Ophthalmol 2010;248:1359-61. https://doi.org/10.1007/s00417-010-1329-6
  6. Wang X, Liu XW, Lee N, Liu QJ, Li WN, Han T, et al. Features of a Chinese family with cerebral cavernous malformation induced by a novel CCM1 gene mutation. Chin Med J (Engl) 2013;126:3427-32.
  7. Kupfs H. Uber heredofamiliare Angiomatose des Gehirens und der Retina, ihre Beziehungen zueinander und zur Angiomatose der Haut. Z Gesamte Neurol Psychiatr 1928;113:651-86. https://doi.org/10.1007/BF02884519
  8. Denier C, Labauge P, Brunereau L, Cave-Riant F, Marchelli F, Arnoult M, et al. Clinical features of cerebral cavernous malformations patients with KRIT1 mutations. Ann Neurol 2004;55:213-20. https://doi.org/10.1002/ana.10804
  9. Gault J, Shenkar R, Recksiek P, Awad IA. Biallelic somatic and germ line CCM1 truncating mutations in a cerebral cavernous malformation lesion. Stroke 2005;36:872-4. https://doi.org/10.1161/01.STR.0000157586.20479.fd
  10. Wustehube J, Bartol A, Liebler SS, Brütsch R, Zhu Y, Felbor U, et al. Cerebral cavernous malformation protein CCM1 inhibits sprouting angiogenesis by activating DELTA-NOTCH signaling. Proc Natl Acad Sci U S A 2010;107:12640-5. https://doi.org/10.1073/pnas.1000132107
  11. Maddaluno L, Rudini N, Cuttano R, Bravi L, Giampietro C, Corada M, et al. EndMT contributes to the onset and progression of cerebral cavernous malformations. Nature 2013;498:492-6. https://doi.org/10.1038/nature12207
  12. Denier C, Labauge P, Bergametti F, Marchelli F, Riant F, Arnoult M, et al. Genotype-phenotype correlations in cerebral cavernous malformations patients. Ann Neurol 2006;60:550-6. https://doi.org/10.1002/ana.20947
  13. Kivelev J, Niemela M, Hernesniemi J. Treatment strategies in cavernomas of the brain and spine. J Clin Neurosci 2012;19:491-7. https://doi.org/10.1016/j.jocn.2011.08.015
  14. Lee ST, Choi KW, Yeo HT, Kim JW, Ki CS, Cho YD. Identification of an Arg35X mutation in the PDCD10 gene in a patient with cerebral and multiple spinal cavernous malformations. J Neurol Sci 2008;267:177-81. https://doi.org/10.1016/j.jns.2007.10.018
  15. Lee YW, Lee ST, Cha JG, Park JH, Jeon BR, Lee YK, et al. A novel KRIT1 gene mutation in a patient with cerebral and multiple spinal cavernous malformations. Ann Clin Lab Sci 2010;40:290-4.

Cited by

  1. Cerebral Glioblastoma Mimicking a Cavernous Malformation: A Case Report and Literature Review vol.3, pp.1, 2016, https://doi.org/10.18679/cn11-6030_r.2017.005