Klassifikation zerebraler vaskulärer Malformationen
Cerebrovascular
malformations • Vein of Galen malformation - Ganzer Fall bei Radiopaedia
Infant with
heart failure. Axial T2 MRI of the brain (above left) shows large vascular flow voids representing the nidus of the lesion along the right hemisphere of the brain and a dilated sagittal sinus. Sagittal US of the midline of the brain (above right) shows a large vascular structure with mixed arterial and venous flow within it that is compressing and displacing the sagittal sinus beneath it. MR angiogram with contrast of the brain (below left) shows a large nidus of arterial vessels along the right cerebral hemisphere fed primarily by the right middle cerebral artery that rapidly drain into a dilated sagittal sinus on the MR venogram (below right).The diagnosis was intracranial arteriovenous malformation with arteriovenous fistula.
Brain stones
revisited—between a rock and a hard place. Axial CT in bone windows (a) and 3D reconstruction (b) of a 33-year-old male with temporal lobe epilepsy. The large amorphous calcification seen at the base of the left temporal lobe in this NCECT represents a known case of an embolised AV malformation. Calcifications are known to appear in 25–30 % of cases in close conjuction with serpentine vessels or within adjacent brain parenchyma
More
images of this case: Arteriovenöse Malformation im Gehirn: MRT TOF gedrehte MIP-Projektion
Imaging to
intervention: a review of what the Interventionalist needs to Know about Hereditary Hemorrhagic Telangiectasia. A and B 12-year-old boy with heterozygous ENG mutation hereditary hemorrhagic telangiectasia and a cerebral capillary vascular malformation. A Late arterial phase lateral projection digital subtraction angiogram of the left internal carotid artery demonstrates a sub centimeter focus of ectasia and blush without arteriovenous shunting in the medial aspect of the left frontal lobe (arrow). B Axial FLAIR sequence showing corresponding focus (arrow)
Imaging to
intervention: a review of what the Interventionalist needs to Know about Hereditary Hemorrhagic Telangiectasia. 32-year-old male who present with a headache. Axial and Coronal T2 weighted images show a cortical nidal AVM within the posterior right frontal lobe measuring 2.5 cm (white arrow)
Cerebrovascular
malformations • Arteriovenous malformation - cerebral - Ganzer Fall bei Radiopaedia
Cerebrovascular
malformations • Sinus pericranii - Ganzer Fall bei Radiopaedia
Cerebrovascular
malformations • Cerebral arteriovenous malformation - Ganzer Fall bei Radiopaedia
Cerebral vascular malformations encompass a large variety vascular lesions which differ in hemodynamics, structure and prognosis. Some can be life threatening (e.g. vein of Galen aneurysmal malformations, arteriovenous malformations) whilst others are almost always incidental and asymptomatic (e.g. capillary telangiectasias, developmental venous anomalies).
Classification
Over the years cerebral vascular malformations have been classified in a variety of ways by many authors, often on the basis of the presence or absence of arteriovenous shunting, histopathological features or demographics of affected individuals (see below) .
Presence or absence of shunting
Cerebral vascular malformations with shunting
- arteriovenous malformation (AVM)
- plexiform nidus
- mixed (plexiform-fistulous) nidus
- cerebral proliferative angiopathy
- arteriovenous fistula
- dural arteriovenous fistula (dAVF)
- dural sinus malformation
- pial or subependymal arteriovenous fistula (AVF)
- vein of Galen aneurysmal malformation (VGAM)
- choroidal (more common)
- mural (less common)
Cerebral vascular malformations without shunting
- capillary telangiectasia
- cavernous venous malformation (cavernoma)
- sinus pericranii
- venous malformation
Morphology
Arterial lesions
- focal arterial lesions
- genetic influences (e.g. arterial aneurysms associated with neurofibromatosis type 1, Ehlers-Danlos syndrome type IV, and familial immune deficiency syndrome)
- segmental arterial lesions
- twin aneurysm and segmental aneurysm
- metameric arterial lesions
- defected mesodermal cell migration gives rise to metameric syndrome or CAMS (craniofacial arteriovenous metameric syndrome), including Wyburn-Mason Syndrome
Capillary lesions
- focal capillary lesions
- associated with hereditary hemorrhagic telangiectasia
- focal lesion at arteriovenous junction may lead to classic AVM, choroidal AVM or dural AV fistula
- segmental capillary lesions
- metameric capillary lesions
Venous lesions
- focal venous lesions
- segmental venous lesions
- metameric venous lesions (also termed as craniofacial venous metameric syndrome)
- Sturge Weber syndrome (non familial)
- blue rubber bleb nevus syndrome (familial)
Pediatric (age dependent)
Some lesions are only encountered in specific age-groups, usually within early childhood.
- in utero: pilal high flow AVF, VGAM, DSM
- neonate: VGAM, pial high flow AVF, DSM
- infant: VGAM, pial AVMs, cavernous angiomas, aneurysm
- child: pial AVM (nidal > fistulous), aneurysm, cavernous venous malformation (cavernoma), dural AVF
Siehe auch:
- Developmental Venous Anomaly
- Arteriovenöse Malformation
- zerebrale arteriovenöse Malformation
- kapilläre Teleangiektasien des ZNS
- Sinus pericranii
- durale AV-Fistel
- mixed vascular malformation
- Kavernom
- intrakranielle vaskuläre Malformationen
- zerebrale vaskuläre Malformationen beim Neugeborenen
- Vena Galeni Malformation
- intrakranielle arteriovenöse Malformationen
- kapilläre Teleangiektasie
und weiter:
Assoziationen und Differentialdiagnosen zu Klassifikation zerebraler vaskulärer Malformationen:
intrakranielle
vaskuläre Malformationen
