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Wyburn-Mason Syndrome
Wyburn Mason's Syndrome

Presentation

The patients suffering from Wyburn-Mason syndrome present with the following clinical presentations of the eye: WMS involves the retina (nerve bundle present at the back of the eye) and the orbit. Retinal involvement is more common. [icliniq.com]

Rarely, it presents with bilateral and symmetrical grade of malformation. We describe a 37-year old male, who presented with Wyburn–Mason syndrome presenting with bilateral but asymmetrical retinal hemangioma. [ijo.in]

Although the retinal lesions will rarely require any therapy, its’ discovery mandates appropriate referral for evaluation of the possibility that a concomitant intracranial lesion may be present. [aaopt.org]

However, our patient presented with different grade of AVM in both the eyes. [journals.lww.com]

Presentation History Neurologic symptoms of Wyburn-Mason syndrome (WMS) are extremely variable and depend on the size, location, and configuration of the central nervous system (CNS) AVM. [emedicine.medscape.com]

Entire Body System

  • Asymptomatic

    It usually is unilateral and often is asymptomatic. An example of a retinal AVM is shown in the image below. Dilated arteriovenous system representing a well-compensated unilateral retinal arteriovenous malformation. [emedicine.medscape.com]

    AVM is not fully known, but several genes such as BMP4 or PAX3 are important in promoting neural crest differentiation and migration in CAMS.8 The treatment of the thyroid AVM in this case of Wyburn-Mason syndrome is expectant, because the lesion is asymptomatic [ajnr.org]

    The first category consists of the patient having small lesions that usually are asymptomatic. [en.wikipedia.org]

  • Pain

    Indications for treatment of a thyroid AVM include disturbances of thyroid function or the development of a painful enlarging goiter indicating intrathyroid hemorrhage, resulting in a painful enlarging goiter. [ajnr.org]

    Volume 1 covers the visual sensory system, the autonomic nervous system, the ocular motor system, the eyelid, facial pain and headache, and nonorganic disease. [books.google.com]

    Yates, AG, Paine, CG: Case of arteriovenous aneurysm within brain. Brain 53: 38–46, 1930. Google Scholar | Crossref 3. Bonnet, P, Dechaume, J, Blanc, E: L'anevrisme cirsoide de la retine. [journals.sagepub.com]

    Google Scholar Yates AG, Paine CG (1930) Case of arteriovenous aneurysm within brain. Brain 53: 38–46. CrossRef Google Scholar Younge BR (1987) Wyburn-Mason syndrome. In: Gomez (ed.) Neurocutaneous Disorders: a practical approach. [link.springer.com]

  • Surgical Procedure

    View videos of surgical procedures and access the complete contents of Retina, 5th Edition online at www.expertconsult.com, fully searchable, with regular updates and a downloadable image gallery. [books.google.com]

    Many intracranial AVMs may be completely removed with a surgical procedure. Some intracranial AVMs, because of their location within the brain, are not considered good candidates for surgical resection. [rarediseases.org]

  • Epilepsy

    Addition of verapamil in the treatment of severe myoclonic epilepsy in infancy. Epilepsy Res 2009; 85 (01) 89-95 69 Polizzi A, Pavone P, Iannetti P, Manfré L, Ruggieri M. Septo-optic dysplasia complex: a heterogeneous malformation syndrome. [thieme-connect.com]

  • Weakness

    The potential complications of Wyburn-Mason Syndrome may include: Loss of vision Hemorrhage or bleeding in the brain Thin or weak blood vessels which may lead to the following: Bulges in the blood vessel wall (aneurysm) Rupture of the blood vessels causing [dovemed.com]

Gastrointestinal

  • Vomiting

    At the age of 5 years, he presented with sudden onset of headache, followed by a loss of consciousness, vomiting, and, subsequently, visual disturbances. [ncbi.nlm.nih.gov]

    Case 1: A 14-year-old boy suddenly suffered from headache and vomiting. A CT-scan and spinal tap revealed a subarachnoid hemorrhage. A huge AVM was demonstrated in the right basal ganglia, extending to the midbrain. [jstage.jst.go.jp]

    Symptoms include loss of vision, severe headache, vomiting and sudden proptosis. In some patients, mental retardation, psychotic symptoms. The syndrome is very rare. More frequent in males; present from birth. Aetiology unknown. [whonamedit.com]

    Vomiting. Seizures. The rigidity of the neck. Paralysis of the cranial nerves. Spontaneous bleeding. Severe headaches. Fluid build-up inside the brain cities (hydrocephalus). [icliniq.com]

    Headache Hemiparesis Visual loss Occasionally present symptoms in 5-29% of the cases: Abnormality of eye movement Cerebral hemorrhage Epistaxis Gingival bleeding Hearing impairment Irritability Iris hypopigmentation Loss of consciousness Nausea and vomiting [dovemed.com]

  • Nausea

    Nausea. Vomiting. Seizures. The rigidity of the neck. Paralysis of the cranial nerves. Spontaneous bleeding. Severe headaches. Fluid build-up inside the brain cities (hydrocephalus). [icliniq.com]

    […] developmental delay Headache Hemiparesis Visual loss Occasionally present symptoms in 5-29% of the cases: Abnormality of eye movement Cerebral hemorrhage Epistaxis Gingival bleeding Hearing impairment Irritability Iris hypopigmentation Loss of consciousness Nausea [dovemed.com]

Skin

  • Cutaneous Manifestation

    Wyburn-Mason syndrome does not cause significant cutaneous manifestations, except for the rare occurrence of small facial angioma over the trigeminal region of the face. [pubmed.ncbi.nlm.nih.gov]

    However, unlike the other neurocutaneous disorders, WMS does not show cutaneous manifestations. The exact cause for the development of Wyburn-Mason syndrome is not known. [icliniq.com]

    In contrast to other phakomatoses, Wyburn-Mason syndrome does not commonly cause cutaneous manifestations. [emedicine.medscape.com]

    Wyburn-Mason syndrome does not cause significant cutaneous manifestations, except for the rare occurrence of small facial angioma over the trigeminal region of the face.[2][3][4][5][1][5] Etiology Wyburn-Mason syndrome is a congenital, nonhereditary, [ncbi.nlm.nih.gov]

Ears

  • Hearing Impairment

    […] symptoms in 30-79% of the cases: Cerebral palsy Facial asymmetry Global developmental delay Headache Hemiparesis Visual loss Occasionally present symptoms in 5-29% of the cases: Abnormality of eye movement Cerebral hemorrhage Epistaxis Gingival bleeding Hearing [dovemed.com]

Eyes

  • Hemianopsia

    At the age of 7 years, he developed acute hemianopsia and right hemiplegia. Angiography revealed large bilateral arteriovenous malformations involving the midbrain thalamic area and the right optic nerve. [ncbi.nlm.nih.gov]

    Subject Blindness; Fluorescein Angiography; Hemianopsia; Humans; Intracranial Arteriovenous Malformations; Male; Middle Aged; optic Chiasm; Optic Disk; Retinal Vessels; Visual Fields Abstract We report a 56-year-old female with a 50-year history of a [collections.lib.utah.edu]

    Central nervous system and vision may be severely impaired: affected individuals may present with acute headache, hemiplegia, and homonymous hemianopsia in half of the cases. [thieme-connect.com]

Neurologic

  • Headache

    At the age of 5 years, he presented with sudden onset of headache, followed by a loss of consciousness, vomiting, and, subsequently, visual disturbances. [ncbi.nlm.nih.gov]

    Case 3: A 9-year-old boy suffered from headache, anorexia and lethalgia. A huge AVM was demonstrated in the chiasmatic region, extending to the bilateral hypothalamus, the basal ganglia, and the right orbit. [jstage.jst.go.jp]

    Affected individuals may have no symptoms or may experience headaches, problems with vision, seizures, or partial paralysis (hemiparesis). [rarediseases.info.nih.gov]

    Common symptoms that lead to diagnosis are headaches, retro-orbital pain, and hemianopia.[5] Visual field of homonymous hemianopia The ophthalmic features of Bonnet–Dechaume–Blanc syndrome occur as retinal arteriovenous malformation (AVMs). [en.wikipedia.org]

  • Intracranial Hemorrhage

    Bonnet–Dechaume–Blanc syndrome Other names Arteriovenous aneurysm of mid-brain and retina, facial nevi and mental changes, Cerebrofacial arteriovenous metameric syndrome type 2 CT scan showing intracranial hemorrhage Specialty Medical genetics Bonnet–Dechaume–Blanc [en.wikipedia.org]

  • Neurologic Manifestation

    Early onset of neurologic manifestations is a poor prognostic factor for long-term outcome. [ncbi.nlm.nih.gov]

    Neurological manifestations are diverse and depend on the location, shape, and size of the AVMs. Patients may exhibit cognitive disorders, headaches, epileptic seizures, or cranial nerve lesions [2, 7, 25, 29]. [journals.eco-vector.com]

    Neurological manifestations in individuals with pure cutaneous or syndromic (Ruggieri-Happle syndrome) phenotypes with “cutis tricolor”: a study of 14 cases. Neuropediatrics 2010; 41 (02) 60-65 50 Ruggieri M, Praticò AD. [thieme-connect.com]

Workup

Her topic of discussion was “The Uveitis Workup: What Not to Miss!” Posted on: Mar 26 2019 By: Lisa Mitchell-Galloy Dr. Sohail Hasan, current President of ISEPS, introduced and led many talks at the recent Annual ISEPS/COS meeting. Dr. [illinoisretina.com]

Treatment

Gamma knife radiosurgery as a single treatment modality for large cerebral arteriovenous malformations. J Neurosurg. 2000 Dec. 93 Suppl 3:113-9. [Medline]. Pollock BE, Gorman DA, Coffey RJ. [emedicine.medscape.com]

Treatment[edit] The treatment for Bonnet–Dechaume–Blanc syndrome is controversial due to a lack of consensus on the different therapeutic procedures for treating arteriovenous malformations.[9] The first successful treatment was performed by Morgan et [en.wikipedia.org]

Prognosis

(Outcomes/Resolutions) The prognosis of Wyburn-Mason Syndrome is dependent upon the severity of the signs and symptoms and their age of onset The prognosis is guarded, if neurological signs and symptoms are manifested at an early age Additional and Relevant [dovemed.com]

The long term prognosis is controversial. Some authors report ocular lesions stability and others report progressive visual loss. Keywords : Angiomatosis; Retina [abnormalities]; Arteriovenous malformations [diagnosis]; Syndrome. [scielo.br]

Prognosis The natural history of WMS is unknown and the management is controversial. Hence, the prognosis of WMS is uncertain. Patients of WMS may remain asymptomatic both visually and systemically. [ncbi.nlm.nih.gov]

[…] compression and chiasmal syndrome. 3 The average life expectancy of patients with VHL is less than 50 years, with morbidity most commonly due to renal cell carcinoma. 1,3,5 Early detection of affected gene carriers can play a critical role in improved prognosis [reviewofoptometry.com]

Does Wyburn-Mason Syndrome Enjoy a Favorable Prognosis? Retinal AVM usually remains stable, and some show spontaneous regression. Patients with cerebral hemorrhage suffer from high mortality. [icliniq.com]

Etiology

The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment. [books.google.com]

Wyburn-Mason syndrome is caused by an anomaly in organogenesis, however the etiology and risk factors are unknown. [atlasrleye.com]

They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]

Although the etiology is still not clear, a recent theory holds that ischemic lung may effect bone and soft-tissue changes by afferent impulses mediated by the vagus nerve. [jamanetwork.com]

Epidemiology

The timing of the insult determines the embryonic tissue that is be affected. [3] Epidemiology Frequency United States Wyburn-Mason syndrome is extremely uncommon, with incidence and prevalence rates that remain poorly defined. [emedicine.medscape.com]

Wyburn-Mason Syndrome: Background, Pathophysiology, Epidemiology ; Jun 30, 2017 ... Wyburn-Mason syndrome (WMS), also known as ... Author: Andrew G Lee, MD; Chief Editor: Hampton Roy, Sr, MD more... Share; Email; Print ... [yinikcze.ga]

Cell phones–homes for microbes R Rana, S Joshi, S Lakhani, M Kaur, P Patel Int J Biol Med Res 4 (3), 3403-6, 2013 17 2013 Risk factors and epidemiological profile of superficial fungal infections in patients of Waghodia Taluka of Vadodara district,India [scholar.google.co.in]

Epidemiology[edit] The syndrome was first described in 1943 and believed to be associated with racemose hemangiomatosis of the retina and arteriovenous malformations of the brain. [en.wikipedia.org]

Pathophysiology

The first chapter stresses the etiology and pathophysiology of childhood stroke as the basis for evaluations and treatment. [books.google.com]

This chapter discusses the historical features, pathophysiology, and treatment options for WMS. Retinal AVMs usually do not grow or bleed, and are usually not responsible for significant visual loss. [cambridge.org]

Prevention

Therefore, no preventive methods or guidelines are available Active research is currently being performed to explore the possibilities for treatment and prevention of inherited and acquired genetic disorders Regular medical screening at periodic intervals [dovemed.com]

There is no definitive treatment to cure Wyburn-Mason Syndrome and treatment is aimed at controlling the symptoms and preventing any complications that may arise due to Arteriovenous Malformations. [epainassist.com]

Integrated Health Sciences 5 (2), 63, 2017 2017 Pediatric Dermatoses: A Study of 313 Cases P Shekhat, R Mahajan, K Ninama, S Lakhani, F Bilimoria Indian Journal of Clinical and Experimental Dermatology 3 (4), 187-193, 2017 2017 Wyburn-Mason syndrome-A rare preventable [scholar.google.co.in]

[…] include embolization, radiation therapy, and continued observation.[5] When pursuing treatment, it is important to consider the size of the malformations, their locations, and neurological involvement.[7] Because it is a congenital disorder, there are no preventative [en.wikipedia.org]

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