The data provide evidence of an association between aneurysm development and a polymorphism at a genetic variant of endoglin in patients with these lesions.
The etiology and mechanism of expansion of primary intracranial arachnoid cysts have been much debated. A rare case of an 8-month-old boy is reported, in which postnatal development and enlargement of a middle cranial fossa arachnoid cyst was detected on follow-up CT scans. Based on intraoperative and histological findings, the cyst was found to be intra-arachnoid. The wall was excised completely, and the lobe adjacent to the cyst appeared normal apart from signs of atrophy. Histological study of the excised cyst revealed a common arachnoid membrane with neither ependymal nor inflammatory cells; the cyst fluid was similar to CSF. The etiology of the lesion remains unclear, but it was considered that the expansion of the cyst might have occurred through a ball-valve mechanism of the membrane in communication with the general subarachnoid space.
The usefulness of magnetic resonance (MR) angiography using the three-dimensional time-of-flight method for the characterization of symptomatic middle cerebral artery (MCA) occlusive lesions was evaluated in 10 patients with MCA occlusion and 10 with MCA stenosis. All lesions were symptomatic and documented by conventional angiography. There was no false-negative MR angiogram that failed to demonstrate the MCA occlusive lesion. MR angiography correctly evaluated the location of lesions and the difference between stenosis and occlusion. Stenosis appeared as a focal signal loss (< 1.0 cm) of the MCA at the site of stenosis, and occlusion as a complete signal loss of the MCA distal to the site of occlusion. However, MR angiography could not distinguish diffuse stenosis and one point stenosis demonstrated by conventional angiography. MR angiography is a useful noninvasive diagnostic method for evaluating occlusive lesions of the MCA in symptomatic patients.
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