Neuroimaging of Cavernous Malformations

Abstract

Gradient echo T2*-weighted imaging and susceptibility-weighted imaging are the recommended imaging protocols for evaluation of suspected CCMs. Diffusion tensor imaging-based tractography provides visualization of the eloquent white matter tracks in the brain. This imaging is increasingly used in clinical practice to assist in selecting the optimal surgical approach, especially for brainstem lesions. Quantitative susceptibility mapping and dynamic contrast-enhanced quantitative perfusion are presently considered experimental. Its proposed value might prove helpful in the future to monitor disease activity and response to treatments. The choice of imaging modality of CCMs depends on the goals the clinician expects to achieve, such as establishing the initial diagnosis, follow-up and monitoring disease activity, preoperative, intraoperative, and postoperative evaluation, or research and experimental work on patients with CCM.

Atlas of Nervous System Vascular Malformations: A Systematic Review

“…On multiple occasions, the obtained images turn out to be similar to arteriovenous malformations (AVM). Therefore, in order to establish a differential diagnosis, digital subtraction angiography (DSA) via catheter may be used [ 17 , 40 ].…”

“…Other more specific studies allow the establishment of differential diagnoses, including those that discern between CAs and AVMs or CAs and CCT, which can be perceived as being similar according to MRI data. Accordingly, the performance of DSA has been recommended [ 17 , 40 ] to distinguish between CAsand. AVMs, and the performance of SWI has been recommended to distinguish between CAs and CCT [ 58 ].…”

“…For these reasons, the surgical approach can be used in some cases. However, endovascular processes are preferred over surgeries in deep lesions that are difficult to access [ 17 , 40 , 80 ]. A crucial element to consider in choosing between sclerotherapy and embolization is the risk of dissemination of the sclerosing agent, which can lead to necrosis and embolization of areas that are not directly affected by vascular malformation.…”

Management of Central Nervous System Cavernomas: An Experience of the Department of Neurosurgery at the Ibn Tofail Hospital, Mohammed VI University Hospital

“…The exact prevalence of cavernomas in the general population is still uncertain. But due to diagnostic advances and the widespread use of MRI in clinical practice; their incidence increased with a prevalence of 0.4% to 0.9% [ 1 - 2 ].…”

“…Cavernomas, also known as cavernous hemangiomas, are congenital vascular anomalies described for the first time by Virchow in 1863. They represent 5% to 10% of cerebral vascular malformations and are usually diagnosed post-mortem during autopsy or as an incidental finding on imaging in 0.4% to 0.8% of cases [ 1 , 2 ]. They can be localized anywhere in the central nervous system.…”