Computerized tomography in vascular malformations of the brain

Area of Science:

• Neuroradiology
• Diagnostic Imaging
• Neurology

Background:

• Intracranial hemorrhage diagnosis relies on imaging modalities.
• Aneurysms and angiomatous malformations are common causes of hemorrhage.
• Differentiating between these vascular lesions is crucial for patient management.

Purpose of the Study:

• To evaluate the diagnostic accuracy of computerized tomography (CT) scans in identifying the source of intracranial hemorrhage.
• To compare CT findings with angiographic and clinical data for aneurysms and angiomatous malformations.
• To assess CT's utility in detecting specific features like vasogenic edema and calcifications.

Main Methods:

• Retrospective review of CT scans from 166 patients (99 with aneurysms, 67 with angiomatous malformations).
• Correlation of CT findings with angiographic and clinical data.
• Analysis of CT scan performance in diagnosing hemorrhage source, lesion size, and associated findings.

Main Results:

• CT identified intracranial hemorrhage in 103 patients.
• CT diagnosed the hemorrhage source with higher certainty in angiomatous malformations (40%) compared to aneurysms (12%).
• CT detected low density lesions (vasogenic edema) in 18 cases and calcifications in 10 angiomas; contrast enhancement aided visualization of smaller lesions.

Conclusions:

• CT is valuable for diagnosing intracranial hemorrhage and its source, especially in angiomatous malformations.
• CT provides complementary information to angiography, particularly for thrombosed giant aneurysms.
• CT can identify angiographically occult angiomas and associated findings like calcifications in Sturge-Weber's disease.