Aneurysm Cryptic AVM Cavernous angioma Venous angioma · Cryptic AVM Cavernous angioma Venous...
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Transcript of Aneurysm Cryptic AVM Cavernous angioma Venous angioma · Cryptic AVM Cavernous angioma Venous...
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Aneurysm
AVM
Cryptic AVM
Cavernous angioma
Venous angioma
Vascular malformation
ssregypt.com
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Aneurysms 1-14% of population
Congenital 97%
Infectious 3%
Arteriosclerotic,traumatic, neoplastic, fibro muscular disease
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Multiple aneurysms 20- 25% Ruptured aneurysm size 5-15mm Largest one 87%
Ant. Communicating artery 70%
Hematoma
Giant aneurysm larger than 2.5 cm 25% of all aneurysms
[Location around the sella [cavernous segment of ICA, basilar tip]
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Aneurysms
NCCT Rarely visualized
Faint hyper density
Calcification,
Subarachnoid hage
CECT Intense homogenous enhancement
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Carotid – cavernous fistula
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Bilateral internal carotid aneurysms
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Partially thrombosed Aneurysm
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Aneurysm
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Mixed signal intensities
• Patent lumen [ signal void]
• Thrombosed lumen [Laminated thrombus of mixed stages]
• Perianeurysmal hemorrhage and edema
1 Vessel
2 Patent lumen
3 Perilumenal hyper intensity
4 Perianeurysmal hemorrhage
5 Thrombosed part
6 Edema
MRI
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bilateral carotid aneurysms
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T1-weighted MRI of a middle-aged woman with progressive headaches, aphasia, and right-sided hemi paresis. A large intracerebral mass with a significant amount of surrounding edema is depicted. The lesion is a giant internal carotid artery aneurysm.
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Arteriovenous malformation
The most common vascular lesion
80% before the end of 4th decade
20% below 20 years
Site Supratentorial 90%
[parietal>frontal> temporal,…]
infratentorial 10%
NCCT mixed density 60% hyper density [
hemorrhage ], hypo density [infarcts]
calcifications 15-30%
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CECT serpigenously enhancing lesion
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MRI
Signal void vessels in all pulse
sequences
before and after enhancement
MR angiography [no contrast
material used]
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AVM
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AVM
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AVM
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occult AVM
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8%- 16% of all cerebro -vascular malformations
? Congenital lesion symptoms 3rd – 5th decades
Multiple lesions 20- 30% of cases
Cavernous angioma
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Size Few mm – few cm
Content Sub acute & chronic blood clots
NCCT Focal hyper dense lesion ± calcifications
no edema, no mass effect
CECT mild enhancement
CT
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MRI Focal area of mixed signal intensity
High signal [ met Hb , thrombosis]
Low signal [deoxy Hb, hemosiderin, calcification]
Hypo intense rim [ hemosiderin ]
Enhancement similar to CT
Angiography negative findings
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Cavernous angioma
F 52 Y
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Cavernous angioma
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Cavernous angioma
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Multiple Cavernous hemangiomas
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Multiple Cavernous hemangiomas
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Multiple Cavernous hemangiomas
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Multiple Cavernous hemangiomas
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Multiple Cavernous hemangiomas
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M 43y
Cavernous hemangioma
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Venous angioma 2%
[From Atlas SW, 1996, MR imaging of brain and spine]
A tuft of abnormally
enlarged medullary
veins draining into a
central venous trunk
Clinically silent ? Normal variant
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[From Atlas SW, 1996, MR imaging of brain and spine]
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venous angioma
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Thank you
نستغفرك و نتوب اليك ×نشهد ان ال اله اال انت ×سبحانك اللهم و بحمدك
Mamdouh Mahfouz MD
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Brain, cavernous angioma. T1-weighted MRI of the classic popcorn like appearance
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venous angioma