Symptomatic capillary telangiectasia of the pons: three pediatric cases diagnosed by suspectibility-weighted imaging

Brain capillary telangiectasias (BCT) are small, clinically benign, usually asymptomatic and rarely seen lesions during childhood. Large symptomatic BCT during childhood are extremely rare, with only a few reports in the literature. They usually cannot be detected easily on conventional magnetic resonance imaging and angiography.

We present the first pediatric case series of large pontine BCT presenting with distinct symptoms and in whom the lesions were detected by susceptibility-weighted imaging (SWI), for the first time to date. SWI provides a crucial imaging modality for BCT.

We suggest that the combination of signal intensity loss on SWI and focal enhancement in a lesion otherwise not seen on conventional MR images is diagnostic for BCT and serves to discard serious differential diagnoses with high specificity, reassuring patients and referring physicians.

We would like to emphasize clinical and radiological findings of BCT and utility of SWI images on MRI for the confirmation of diagnosis in the pediatric age group.