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CT patterns in histopathologically complex cavernous hemangiomas
Insights
Computed tomographic (CT) scans and microscopic analysis revealed that some cavernous hemangiomas contain multiple cerebrovascular malformations, increasing the risk of hemorrhage.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Cavernous hemangiomas are vascular malformations in the brain.
- Coexistence of multiple cerebrovascular malformations is rare.
Purpose of the Study:
- To correlate computed tomographic (CT) findings with histopathological results in cavernous hemangiomas.
- To investigate the occurrence and implications of multiple cerebrovascular malformations within a single lesion.
Main Methods:
- Retrospective analysis of 10 histologically verified cavernous hemangiomas from nine patients.
- Correlation of computed tomographic (CT) imaging data with detailed microscopic examination of lesion pathology.
Main Results:
- In 40% of cases (4 of 10 lesions), multiple types of cerebrovascular malformations (arteriovenous malformations, venous malformations, telangiectasis) were found within a single cavernous hemangioma.
- Hemorrhage (recent or old) was present in all four cases with combined malformations.
- CT findings were nonspecific and did not differentiate these complex lesions from other intracranial pathologies.
Conclusions:
- Cavernous hemangiomas can rarely present as combined cerebrovascular malformations.
- The presence of multiple malformations within a cavernous hemangioma is associated with hemorrhage.
- CT imaging alone is insufficient to diagnose complex vascular malformations within cavernous hemangiomas.
Abstract:
Computed tomographic (CT) studies were correlated with microscopic findings in 10 histologically verified cavernous hemangiomas in nine patients. In four of the 10 lesions, two or more distinct types of cerebrovascular malformations were identified histopathologically. These included arteriovenous malformations, venous malformations, and telangiectasis. Such coexistence of various types of cerebrovascular malformations has been reported rarely. In each of the four combined lesions, there was evidence of recent or old hemorrhage. The CT findings were nonspecific and were similar to those seen in a variety of intracranial pathologic conditions.