A case of cavernous angioma of the cerebellar vermis is described. Cevernous angioma is rare vascular malformation of the central nervous system and the cerebellar vermis is very unusual site. Exact preoperative diagnosis of this lesion is difficult because cavernous angioma is angiographically silent and generally accepted to be very rare. The relevant literature is reviewed.
Central Nervous System ; Diagnosis ; Hemangioma ; Hemangioma, Cavernous* ; Vascular Malformations

PURPOSE: To evaluate the MR findings of dural arteriovenous fistula(DAVF) in the cavernous sinus and to determine the most useful imaging method for the diagnosis of DAVF. MATERIALS AND METHODS: We evaluated the MR findings of 12 patients in whom DAVF was diagnosed in the cavernous sinus on the basis of angiographic findings. Axial T1- and T2-weighted, and axial and coronal Gd-enhanced T1-weighted images with 3-6mm slice thickness had been obtained, and the findings of DAVF on three pulse sequences were examined and compared. On the basis of the detection of DAVF on three pulse sequences, the MR findings were graded as excellent, fair or poor, and the location of DAVF in the cavernous sinus was analysed. We also classified DAVFs as group A or B on the basis of MR findings (group A: lesions in the cavernous sinus were as large as or larger than the cavernous internal carotid artery; group B: these were smaller than the cavernous internal carotid artery) and compared with cognard type on angiogram. RESULTS: Multiple tortuous signal voids were found in all DAVFs. The signal voids were located mainly in the middle and posterior one third of the cavernous sinus, as seen on axial images, and the middle and inferior one third, as seen on coronal images. Axial and coronal enhanced T1-weighted images showed an excellent grade in 11 of 12 cases and a fair grade in 1 of 12. Axial T2-weighted images showed an excellent grade in 6 of 12 cases and a fair grade in 4 of 12. T1-weighted images showed an excellent grade in 4 of 12 cases and a fair grade in 6 of 12. Six cases were group A, and 5 of the 6 were Cognard type IIa or IIb; The other 6 cases were group B, 5 of the 6 were Cognard type I. CONCLUSION: MR findings of multiple tortuous signal voids in the cavernous sinus, especially in the posterior or inferior portion, suggest DAVF, and enhanced T1-weighted imaging could be the most useful sequence for its diagnosis.
Arteriovenous Fistula ; Carotid Artery, Internal ; Cavernous Sinus* ; Central Nervous System Vascular Malformations* ; Diagnosis ; Humans

Persistent primitive trigeminal artery (PPTA) is the most common carotid-basilar anastomosis; on the other hand, persistent primitive otic artery (PPOA) is extremely rare. PPTA is often misdiagnosed as PPOA on cerebral angiography. We present a case of PPTA that mimicked PPOA on cerebral angiography. We further describe the utility of brain computed tomography angiography for differential diagnosis of PPTA from PPOA, together with a review of previous literature.
Angiography ; Arteries* ; Brain ; Central Nervous System Vascular Malformations ; Cerebral Angiography* ; Diagnosis, Differential ; Hand

Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.
Aged ; Central Nervous System Vascular Malformations ; physiopathology ; therapy ; Embolization, Therapeutic ; methods ; Humans ; Paraplegia ; diagnosis

Cerebral cavernous malformations (CMs) are vascular malformations of the central nervous system, which can be detected in the absence of any clinical symptoms. Nodules and cysts with mixed signal intensity and a peripheral hemosiderin rim are considered brain magnetic resonance imaging (MRI) findings typical of CMs. A 48-year-old man was admitted to our hospital because of abnormal MRI findings without significant neurological symptoms. A cyst with an internal fluid-fluid level was found in the left basal ganglia on the initial brain MRI. We decided to observe the natural course of the asymptomatic lesion with serial MRI follow-up. On MRI at the 5-month follow-up, the cystic mass was enlarged and showed findings consistent with those of cystic CM. Surgical resection was performed and the pathological diagnosis was CM. Our experience suggests that the initial presentation of a CM can be a pure cyst and neurosurgeons should consider the likelihood of CMs in cases of cystic cerebral lesions with intracystic hemorrhage.
Basal Ganglia ; Brain ; Central Nervous System ; Diagnosis ; Follow-Up Studies ; Hemangioma, Cavernous, Central Nervous System* ; Hemorrhage ; Hemosiderin ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Vascular Malformations

Spinal dural arteriovenous fistulas are rare abnormal connections of arteries and veins on the surface of the dura. A male presenting with myelopathy, which had a slowly progressive course for about 28 months, was diagnosed by magnetic resonance imaging and selective angiography. After surgical coagulation and excision, his symptoms were mildly improved. We report here on a man who underwent a surgical procedure for his myelopathy that was due to spinal arteriovenous fistula. Although it is unusual, spinal arteriovenous fistula should be considered when making a differential diagnosis of myelopathy.
Angiography ; Arteries ; Arteriovenous Fistula ; Central Nervous System Vascular Malformations* ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Male ; Spinal Cord Diseases* ; Veins

The authors report a rare case of spinal dural arteriovenous fistula (DAVF) that supplied by lateral sacral artery. A 71-year-old female initially presented with paraparesis and boring pain on lower extremities. Though magnetic resonance imaging suggested a possible spinal DAVF, routine angiographic evaluation was negative. Thereafter, the patient deteriorated progressively and became paraplegic. Definite diagnosis was made through selective pelvic angiogram. The patient was subsequently treated with embolization using mixture of glue and lipiodol. On three months after the embolization, the patient remained paraplegic, but her leg pain was improved remarkably.
Adhesives ; Aged ; Arteries* ; Central Nervous System Vascular Malformations* ; Diagnosis ; Ethiodized Oil ; Female ; Humans ; Leg ; Lower Extremity ; Magnetic Resonance Imaging ; Paraparesis

A 68-year-old man developed mild quadriparesis 1 month prior to presentation. At 4 days before presentation, he developed dysarthria and more severe quadriparesis, predominantly on the left side of the body. MRI revealed edematous lesions in the medulla and throughout the spinal cord. Angiography showed a right tentorial dural arteriovenous fistula (DAVF). Despite successful treatment achieved by endovascular embolization, there was no improvement in the weakness of either leg. Early diagnosis of tentorial DAVF is important to prevent neurological complications such as encephalomyelopathy and hemorrhage.
Aged ; Angiography ; Central Nervous System Vascular Malformations* ; Dysarthria ; Early Diagnosis ; Hemorrhage ; Humans ; Leg ; Magnetic Resonance Imaging ; Quadriplegia ; Spinal Cord

Aged ; Central Nervous System Vascular Malformations ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord ; blood supply

Spinal dural arteriovenous fistula (SDAVF) is the most common spinal vascular malformation, however it is still rare and underdiagnosed. Magnetic resonance imaging findings such as spinal cord edema and dilated and tortuous perimedullary veins play a pivotal role in the confirmation of the diagnosis. However, spinal angiography remains the gold standard in the diagnosis of SDAVF. Classic angiographic findings of SDAVF are early filling of radicular veins, delayed venous return, and an extensive network of dilated perimedullary venous plexus. A series of angiograms of SDAVF at different locations along the spinal column, and mimics of serpentine perimedullary venous plexus on MR images, are demonstrated. Thorough knowledge of SDAVF aids correct diagnosis and prevents irreversible complications.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Central Nervous System Vascular Malformations/*diagnosis/epidemiology/etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Cord Diseases/diagnosis ; Spine/radiography