Abstract
BACKGROUNDDiagnosis of a microarteriovenous malformation (micro-AVM) is difficult, especially in the acute stage of rupture because of the small size of the nidus and the existence of hematoma. We report two cases of ruptured micro-AVMs detected by arterial spin labeling (ASL).OBSERVATIONSIn one case, a 45-year-old male was transported with a complaint of right hemiparesis. Computed tomography (CT) revealed a right parietal lobar hemorrhage. Standard magnetic resonance imaging (MRI) showed no abnormal findings as the cause of the hemorrhage. ASL 23 days after the onset demonstrated high signals on the medial wall of the hematoma. Digital subtraction angiography (DSA) showed a micro-AVM in accordance with the site of high signals on ASL. In another case, a 38-year-old female was transported with a complaint of left hemianopsia. CT on admission revealed a right parietal lobar hemorrhage. Standard MRI showed no abnormal findings as the cause of the hemorrhage. ASL 15 days after the onset demonstrated high signals on the internal wall of the hematoma. DSA showed micro-AVM in accordance with the site of high signaling on ASL. Both cases were successfully treated with open surgery.LESSONSASL can manifest micro-AVMs as high signals within the hematoma. ASL is a useful less-invasive screening tool for the detection of ruptured micro-AVMs.
Highlights
Diagnosis of a microarteriovenous malformation is difficult, especially in the acute stage of rupture because of the small size of the nidus and the existence of hematoma
Micro-arteriovenous malformation (AVM) are defined as a subgroup of pial AVMs characterized by a nidus of 1 cm or smaller.[6]
Slow flow within the nidus, intralesional thrombosis, posthemorrhagic vascular spasm, or compression of the nidus by the hematoma may account for the lack of visualization of a micro-AVM in the acute stage of rupture.[9,10]
Summary
Diagnosis of a microarteriovenous malformation (micro-AVM) is difficult, especially in the acute stage of rupture because of the small size of the nidus and the existence of hematoma. Digital subtraction angiography (DSA) showed a micro-AVM in accordance with the site of high signals on ASL. In another case, a 38-year-old female was transported with a complaint of left hemianopsia. DSA showed micro-AVM in accordance with the site of high signaling on ASL Both cases were successfully treated with open surgery. ASL is a useful less-invasive screening tool for the detection of ruptured micro-AVMs. KEYWORDS arterial spin labeling; micro-arteriovenous malformation; intracerebral hematoma; surgery. Digital subtraction angiography (DSA) is the gold standard for the definitive diagnosis of AVMs. MRI is a less invasive screening tool that can be used to diagnose AVMs, which are detected as signal flow voids within a hematoma in the acute stage of rupture. We report two cases of ruptured micro-AVMs successfully detected with ASL
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
