Cavernous angiomas of the central nervous system are angiographically occult vascular lesions and are easily diagnosed by magnetic resonance imaging (MRI). Giant cavernous angiomas (GCA) are rare, with only 11 cases reported in the literature. Imaging appearance of GCAs has not been reviewed previously. We report a GCA of the temporal lobe, and discuss its computed tomography and MRI findings in the view of the literature. Imaging appearance of GCAs is variable. Some GCAs have features that are similar to those of typical cavernous angiomas, whereas some lesions may be purely cystic; and some present with significant contrast enhancement and mass effect, mimicking neoplasms. While the presence of hemosiderin, blood degradation products, and calcification may be helpful in the diagnosis of some cases, the correct diagnosis is not apparent until histopathological evaluation of the specimen is made in many instances.
Central nervous system involvement in trichinosis is not rare. Brain lesions in trichinosis have been defined on computed tomography and magnetic resonance imaging (MRI) as multifocal small lesions located in the cerebral cortex and white matter. We present a case of trichinosis with multifocal lesions of the brain detected by MRI and diffusion weighted MRI. Evolutions of these lesions from acute through chronic stages on follow up studies are also presented. This is the first report describing sequential MRI findings and diffusion weighted imaging appearance of brain lesions in trichinosis. Sequential evaluation of conventional and diffusion MR data allowed us to conclude that multifocal lesions in the brain were related to multiple infarctions rather than true inflammatory infiltration of the brain parenchyma.
A 58-year-old man presented with a sudden onset gait disturbance and urinary incontinence. Magnetic resonance (MR) imaging and MR angiography showed a fusiform basilar artery aneurysm, 2 cm in diameter and 5 cm long. The aneurysm was thrombosed except the ectatic basilar artery flowing through it. Compression of the cerebrospinal fluid (CSF) pathways caused obstructive hydrocephalus with resultant transependymal CSF leakage. Conventional angiography missed the aneurysm. A one-sided ventriculoperitoneal shunt was placed to treat the patient's hydrocephalus. The patient's symptoms improved after surgery. MR imaging and MR angiography were useful noninvasive methods of detecting the aneurysm, defining its relationship with surrounding structures, and determining the cause of the hydrocephalus.
A 58-year-old man presented with a sudden onset gait disturbance and urinary incontinence. Magnetic resonance (MR) imaging and MR angiography showed a fusiform basilar artery aneurysm, 2 cm in diameter and 5 cm long. The aneurysm was thrombosed except the ectatic basilar artery flowing through it. Compression of the cerebrospinal fluid (CSF) pathways caused obstructive hydrocephalus with resultant transependymal CSF leakage. Conventional angiography missed the aneurysm. A one-sided ventriculoperitoneal shunt was placed to treat the patient's hydrocephalus. The patient's symptoms improved after surgery. MR imaging and MR angiography were useful noninvasive methods of detecting the aneurysm, defining its relationship with surrounding structures, and determining the cause of the hydrocephalus.
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