Learning objectives
Describe the clinical features of vascular malformations of the brain.
Identify the Imaging features that help differentiate brain arteriovenous malformations from other vascular brain lesions.
Discuss how the radiology report should be in these cases including MRi,
CT and DSA.
Background
Cerebral vascular malformations (CVM) include all those alterations in the correct development of the cerebral vascular system.
They include diseases that affect arteries,
veins and capillaries.
DSA is the gold standard method used for the diagnosis,
but recent adavances in MRi and CT are a good non-invasive alternatives.
The traditional pathologic classification of cerebro vascular malformation (CVMs) is based on the caliber,
configuration,
and histologic composition of the component vessels; their relationship to the normal cerebral vasculature; and the presence/ amount of the intervening brain...
Imaging findings OR Procedure details
Intraxial Vascular Malformations:
A.
CVMswith arteriovenous shunting:
1.
ARTERIOVENOUS MALFORMATION:
Brain AVMs,
or (more specifically) pial AVMs,
are abnormal connections between arteries that would normally supply the brain tissue (pial vessels) and veins that normally drain the brain,
resulting in arteriovenous shunting with an intervening network of vessels within the brain parenchyma and lack of a true capillary bed.The transition between artery and vein can take place via a so-called nidus (a tangle of abnormal vessels located in the brain parenchyma) or can be direct...
Conclusion
The radiologist must identify,
understand and correctly classify vascular malformations.
It should realize an appropriate report to be useful for the clinician and the patient.
Information imaging tests are essential to determinate the most appropriate therapeutic approach to each case.
References
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Classification of vas-
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2.
Wagner BJ,
Richardson KJ,
Moran AM,
Carrier DA.
Intracranial vascular malformations.
Semin Ultra-
sound CT MR 1995;16(3):253–268.
3.
Zabramski JM,
Henn JS,
Coons S.
Pathology of cer-
ebral vascular malformations.
Neurosurg Clin N Am
1999;10(3):395–410.
Berenstein A,
Lasjaunias P,
terBrugge KG.
Surgical
neuroangiography.
2.1.
Clinical and endovascular
treatment aspects in adults.
2nd ed.
Berlin: Springer,
2004.
4.
Friedlander RM.
Clinical practice: arteriovenous
malformations of the...