ABSTRACT
The clinical findings of intracranial vascular malformations are strictly related to their morphologic, angioarchitectural and hemodynamic characteristics. An overall study of these features is the first step to understand the different classifications for arteriovenous malformations, dural arteriovenous fistulas and carotid-cavernous fistulas. This evaluation will also suggest the correct timing of endovascular treatment and which part of the lesion should be the target of the therapy. Conventional cerebral angiography is mandatory when a correct classification of intracranial arteriovenous malformative shunts must be achieved. The angioarchitectural classification of brain arteriovenous malformations considers all angiographic features of each component of the malformation, both morphologically and hemodynamically, and relates them to the clinical course of the disease. The correlation between clinical findings, angiographic features and classifications is even stronger for cranial dural arteriovenous fistulas, in which cortical venous drainage is typical of "aggressive" fistulas and is usually absent in the "benign" type. Similarly, carotid-cavernous fistulas can be differentiated at angiography into high or low flow lesions according to the flow rate of the shunt, and into direct or indirect fistulas, according to the origin of arterial feeders. This paper focuses on the existing relation between the hemodynamics of brain arteriovenous malformations, cranial dural arteriovenous fistulas, carotid-cavernous fistulas, and their most frequent clinical findings, through an analysis of the most widely used different classification systems.
ABSTRACT
SUMMARY: We describe a 22-year-old woman admitted to hospital in emergency with nuchal headache and vomiting. CT scan disclosed subarachnoid hemorrhage. Digital subtraction angiography with three-dimensional rotational acquisitions showed a ruptured aneurysm of a right persistent primitive hypoglossal artery as the cause of symptoms and hemorrhage. The patient was successfully treated with endovascular coiling of the aneurysm. This is the second literature report describing endovascular treatment in this unusual condition.
ABSTRACT
A total of 78 pregnant patients who had previously been studied by ultrasound (US) underwent magnetic resonance (MRI) because of suspected fetal abnormality. The first 20 cases were performed using fetal curarization. Even in the 27 cases in which the MR examination concerned other body regions, a brain study was always performed to analyze the normal anatomy at different gestational ages. There is a brief discussion on normal MRI anatomy of the fetal brain. There were 45 studies that concerned central nervous system pathology, and the most frequent malformative and neoplastic disorders were revealed. A comparison between MRI and US is proposed for each. In conclusion, MRI can be regarded as a complementary method that can be helpful in the rare cases when the US diagnosis is doubtful.
Subject(s)
Brain/abnormalities , Brain/embryology , Female , Humans , Magnetic Resonance Imaging , PregnancyABSTRACT
We report a patient suffering from neurofibromatosis type 1 in whom neoplasms developed from the areas of altered signal which are generally considered benign and typical of the disease. MRI, despite two previous examinations 3 and 2 years before development of the tumour, gave no clue to an unfavourable outcome.
Subject(s)
Brain Neoplasms/pathology , Cell Transformation, Neoplastic/pathology , Neurofibromatosis 1/pathology , Adult , Arnold-Chiari Malformation/genetics , Arnold-Chiari Malformation/pathology , Astrocytoma/genetics , Astrocytoma/pathology , Brain/pathology , Cell Transformation, Neoplastic/genetics , Cerebellar Neoplasms/genetics , Cerebellar Neoplasms/pathology , Follow-Up Studies , Genetic Carrier Screening , Humans , Magnetic Resonance Imaging , Male , Neoplasm Recurrence, Local/genetics , Neoplasm Recurrence, Local/pathology , Neurofibromatosis 1/geneticsABSTRACT
We examined 21 patients with ischemic cerebrovascular disease using magnetic resonance angiography and transcranial Doppler. In 17 patients (81%), the results obtained by the two methods were concordant. In our opinion, the associated use of transcranial Doppler and magnetic resonance angiography provides an accurate diagnostic evaluation of ischemic stroke patients, not only allowing the site of possible steno-occlusive disease of large and medium cerebral vessels to be identified, but also offering the possibility of obtaining dynamic information concerning the direction of blood flow in the presence of compensatory circulations at the level of Willis' circle.
Subject(s)
Brain Ischemia/diagnosis , Brain/pathology , Cerebral Angiography , Echoencephalography , Magnetic Resonance Imaging , Adult , Aged , Brain/diagnostic imaging , Brain Ischemia/diagnostic imaging , Cerebral Arteries/diagnostic imaging , Female , Humans , Male , Middle AgedSubject(s)
Cerebrovascular Disorders/diagnosis , Magnetic Resonance Imaging , Adult , Aged , Arterial Occlusive Diseases/diagnosis , Carotid Artery, External/diagnostic imaging , Carotid Artery, External/pathology , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Stenosis/diagnosis , Cerebral Angiography , Child , Female , Humans , Jugular Veins/physiopathology , Male , Middle Aged , UltrasonographyABSTRACT
Few MRI studies have been performed on subjects with Von Recklinghausen's neurofibromatosis. This not very well-known disease present lesions which in many cases do not appear on CT scans but may be detected by MRI. The nature of such lesions is still controversial. This paper will describe the case of a 7 year-old girl with neurofibromatosis. MRI examination revealed altered signals in some areas: in the basal nuclei, in the brainstem and in the white matter of the cerebellar hemispheres.
