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Computerized tomography findings in arteriovenous malformations of the brain
Insights
Computerized tomography (CT) scans reveal key brain arteriovenous malformation (AVM) indicators. Findings correlate CT results with clinical presentation, aiding diagnosis and understanding of AVMs.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Brain arteriovenous malformations (AVMs) are complex vascular abnormalities.
- Accurate diagnosis and characterization of AVMs are crucial for patient management.
Purpose of the Study:
- To evaluate the utility of computerized tomography (CT) in diagnosing and characterizing brain arteriovenous malformations (AVMs).
- To correlate CT findings with clinical presentations, including intracranial hemorrhage and seizure disorders.
- To assess the diagnostic yield of intravenous contrast enhancement in AVM detection.
Main Methods:
- Retrospective review of CT scans from 54 patients diagnosed with brain AVMs.
- Classification of patients based on clinical presentation: intracranial hemorrhage, seizure disorder, or other neurological disturbance.
- Analysis of CT findings, including hematoma presence, ventricular involvement, lesion characteristics, and vascular abnormalities.
- Correlation of CT findings with clinical, angiographic, and histological data.
Main Results:
- CT scans identified brain hematomas in all patients presenting with intracranial hemorrhage.
- Ventricular hemorrhage correlated with severe neurological dysfunction.
- High-density lesions without mass effect were observed in 48% of patients with seizure disorders.
- Intravenous contrast enhancement improved diagnostic information in 31 of 35 patients.
- Prominent feeding arteries or draining veins were noted in 20% of large AVMs.
- Six cases of angiographically occult AVMs were identified.
Conclusions:
- CT is a valuable tool for evaluating brain AVMs, particularly in cases of hemorrhage.
- CT findings can help differentiate clinical presentations of AVMs.
- Intravenous contrast administration enhances the detection and characterization of AVMs.
- CT plays a significant role in the diagnostic workup of patients with suspected brain AVMs.
Abstract:
Computerized tomography (CT) scans of 54 patients with an arteriovenous malformation (AVM) of the brain were reviewed. The 31 males and 23 females (mean age: 33 years) were classified according to clinical presentation: 1) intracranial hemorrhage (30 patients); 2) seizure disorder (19 patients); and 3) other neurological disturbance (five patients). A brain hematoma was identified in all of the patients in the hemorrhage group have a CT scan within 1 week of the bleed. Extension of hemorrhage into the ventricular system as seen in eight cases was invariably accompanied by severe neurological dysfunction. A high-density lesion without associated mass effect was found in 48% of patients presenting with a seizure disorder. Dilatation of the ipsilateral lateral ventricle, a common finding in this group of patients, was thought to indicate an atrophic process. Evidence of discrete brain infarction was unusual. Intravenous infusion with Hypaque provided additional information in 31 of the 35 patients so studied. Demonstration of prominent or enlarged feeding arteries and/or draining veins occurred in 20% of patients with large malformations. Six cases of angiographically occult AVM's were found. A correlation of the CT scan with clinical, angiographic, and histological findings is presented.