CT in the diagnosis of cerebral vascular malformations

In 72 patients with spontaneous intracranial haemorrhage and vascular malformation, 27 of 49 arterial aneurysms were diagnosed by CT (the smallest one of 4mm diameter being stalked), as were all (18) of the arteriovenous aneurysms (angiomas), but of the venous malformations (5) only 2 (aneurysms of the vein of Galen) were so diagnosed. In the 25 patients with spontaneous subarachnoid haemorrhage, in whom vascular malformation had not been diagnosed through angiography or CT, CT showed the position and extent of the parenchymatous lesion or the existence of blood in the subarachnoid space or ventricules. Finally, in 15 patients with subjective or neuropsychiatric disturbances, 9 arterial and 6 arteriovenous aneurysms were diagnosed by CT and were verified by angiography, which would probably not have been performed if CT had not been performed. Thus it is clear that vascular malformations are often diagnosed by CT. In many cases information is revealed which would not be suspected with angiography, while in other cases angiography is more selective and accurate.