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Clinical and computed tomographic findings in thrombosed and cryptic cerebrovascular malformations
Insights
Angiographically occult or thrombosed cerebrovascular malformations, often presenting as intracranial hemorrhage or seizures, were analyzed. These cryptic vascular malformations showed a better clinical prognosis than previously reported.
Area of Science:
- Neurology
- Neuroradiology
- Vascular Neurology
Background:
- Angiographically occult or thrombosed cerebrovascular malformations are challenging to diagnose.
- These lesions can present with intracranial hemorrhage or seizures.
Purpose of the Study:
- To analyze the presentation and outcomes of patients with angiographically occult or thrombosed cerebrovascular malformations.
- To evaluate the diagnostic utility of CT and angiography in these cases.
Main Methods:
- Analysis of ten patients with angiographically occult or thrombosed cerebrovascular malformations.
- Review of CT and angiographic findings.
- Comparison with a review of 200 cases of spontaneous intracerebral hemorrhage.
Main Results:
- Seven patients presented with intracranial hemorrhage, three with seizures.
- CT revealed hyperdense (9) or isodense (1) lesions; hematoma was confirmed in 3.
- Angiography showed avascular mass (7) or was normal (3); repeat studies showed non-visualization in 2 cases.
Conclusions:
- Cryptic vascular malformations or aneurysms are a potential cause of acute hematoma without evident vascular abnormalities.
- The clinical prognosis for these malformations appears to be better than previously documented.
Abstract:
Ten patients with angiographically occult or thrombosed cerebrovascular malformations were analyzed. Seven patients initially presented with an episode of intracranial hemorrhage; three others presented with a seizure disorder. CT showed hyperdense (9) or isodense (1) lesion; the hyperdense portion was proven to be hematoma in 3. Enhancement was seen in 6 cases and was absent in 4. Angiography showed either avascular mass (7) or was normal (3). In 2 cases, angiographic studies showed non-visualization of abnormal vessels on repeat study. In a review of 200 cases of spontaneous intracerebral hemorrhage, nine young patients had CT evidence of an acute hematoma but no angiographic or pathological evidence of abnormal vessels; and it was postulated that these represented cryptic vascular malformations or aneurysms. The clinical prognosis for both the angiographically occult (thrombosed) or cryptic cerebrovascular malformations was better than reported in previous studies.