Neuroimaging of Hemorrhage and Vascular Malformations

ABSTRACT

Nontraumatic spontaneous intracranial hemorrhage occurs most commonly into the subarachnoid space and brain parenchyma, in contrast to subdural and epidural hematomas that are usually traumatic. The differential diagnosis of nontraumatic subarachnoid hemorrhage includes intracranial aneurysm rupture and vascular malformations, both of which may be investigated noninvasively with computed tomography and magnetic resonance imaging. An isolated intraparenchymal hematoma may be caused by hypertensive vasculopathy, amyloid angiopathy, vascular malformations, or by primary or secondary neoplasms. Knowledge of the appearance of intracerebral vascular malformations will help clinicians request appropriate further imaging and direct treatment.

KEYWORDS

Arteriovenous malformations - cavernous angioma - cerebral amyloid angiopathy - developmental venous anomaly - vascular malformations - MRI - CT

REFERENCES

• 1 Sutherland G R, Auer R N. Primary intracerebral hemorrhage.  J Clin Neurosci. 2006;  13 511-517
• 2 Parizel P M, Makkat S, Van Miert E et al.. Intracranial hemorrhage: principles of CT and MRI interpretation.  Eur Radiol. 2001;  11 1770-1783
• 3 Butcher K S, Baird T, MacGregor L et al.. Perihematomal edema in primary intracerebral hemorrhage is plasma derived.  Stroke. 2004;  35 1879-1885
• 4 Wagner K R, Xi G, Hua Y et al.. Lobar intracerebral hemorrhage model in pigs: rapid edema development in perihematomal white matter.  Stroke. 1996;  27 490-497
• 5 Del Bigio M R, Yan H J, Buist R, Peeling J. Experimental intracerebral hemorrhage in rats. Magnetic resonance imaging and histopathological correlates.  Stroke. 1996;  27 2312-2319 , discussion 2319–2320
• 6 Enzmann D R, Britt R H, Lyons B E, Buxton J L, Wilson D A. Natural history of experimental intracerebral hemorrhage: sonography, computed tomography and neuropathology.  AJNR Am J Neuroradiol. 1981;  2 517-526
• 7 Atlas S W, Grossman R I, Gomori J M et al.. Hemorrhagic intracranial malignant neoplasms: spin-echo MR imaging.  Radiology. 1987;  164 71-77
• 8 Anzalone N, Scotti R, Riva R. Neuroradiologic differential diagnosis of cerebral intraparenchymal hemorrhage.  Neurol Sci. 2004;  25(S1) S3-S5
• 9 Butcher K, Laidlaw J. Current intracerebral haemorrhage management.  J Clin Neurosci. 2003;  10 158-167
• 10 Osborn A G. Brain: 100 Top Diagnoses. Salt Lake City, UT; WB Saunders 2002: 303
• 11 Nieuwkamp D J, de Gans K, Rinkel G J, Algra A. Treatment and outcome of severe intraventricular extension in patients with subarachnoid or intracerebral hemorrhage: a systematic review of the literature.  J Neurol. 2000;  247 117-121
• 12 Attems J. Sporadic cerebral amyloid angiopathy: pathology, clinical implications, and possible pathomechanisms.  Acta Neuropathol. 2005;  110 345-359
• 13 Zhang-Nunes S X, Maat-Schieman M L, van Duinen S G et al.. The cerebral beta-amyloid angiopathies: hereditary and sporadic.  Brain Pathol. 2006;  16 30-39
• 14 Knudsen K A, Rosand J, Karluk D, Greenberg S M. Clinical diagnosis of cerebral amyloid angiopathy: validation of the Boston criteria.  Neurology. 2001;  56 537-539
• 15 Chao C P, Kotsenas A L, Broderick D F. Cerebral amyloid angiopathy: CT and MR imaging findings.  Radiographics. 2006;  26 1517-1531
• 16 Greenberg S M, Finklestein S P, Schaefer P W. Petechial hemorrhages accompanying lobar hemorrhage: detection by gradient-echo MRI.  Neurology. 1996;  46 1751-1754
• 17 Haacke E M, DelProposto Z S, Chaturvedi S et al.. Imaging cerebral amyloid angiopathy with susceptibility-weighted imaging.  AJNR Am J Neuroradiol. 2007;  28 316-317
• 18 Greenberg S M, Eng J A, Ning M, Smith E E, Rosand J. Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage.  Stroke. 2004;  35 1415-1420
• 19 Jellinger K A, Lauda F, Attems J. Sporadic cerebral amyloid angiopathy is not a frequent cause of spontaneous brain hemorrhage.  Eur J Neurol. 2007;  14 923-928
• 20 Koennecke H C. Cerebral microbleeds on MRI: prevalence, associations, and potential clinical implications.  Neurology. 2006;  66 165-171
• 21 Viswanathan A, Chabriat H. Cerebral microhemorrhage.  Stroke. 2006;  37 550-555
• 22 Prada C M, Garcia-Alloza M, Betensky R A et al.. Antibody-mediated clearance of amyloid-beta peptide from cerebral amyloid angiopathy revealed by quantitative in vivo imaging.  J Neurosci. 2007;  27 1973-1980
• 23 Al-Shahi R, Warlow C. A systematic review of the frequency and prognosis of arteriovenous malformations of the brain in adults.  Brain. 2001;  124 1900-1926
• 24 Stapf C, Mast H, Sciacca R R et al.. The New York Islands AVM Study: design, study progress, and initial results.  Stroke. 2003;  34 e29-e33
• 25 Stapf C, Mohr J P, Choi J H, Hartmann A, Mast H. Invasive treatment of unruptured brain arteriovenous malformations is experimental therapy.  Curr Opin Neurol. 2006;  19 63-68
• 26 Stapf C, Mast H, Sciacca R R et al.. Predictors of hemorrhage in patients with untreated brain arteriovenous malformation.  Neurology. 2006;  66 1350-1355
• 27 Choi J H, Mast H, Sciacca R R et al.. Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation.  Stroke. 2006;  37 1243-1247
• 28 Labauge P, Denier C, Bergametti F, Tournier-Lasserve E. Genetics of cavernous angiomas.  Lancet Neurol. 2007;  6 237-244
• 29 Jain R, Robertson P L, Gandhi D et al.. Radiation-induced cavernomas of the brain.  AJNR Am J Neuroradiol. 2005;  26 1158-1162
• 30 Raychaudhuri R, Batjer H H, Awad I A. Intracranial cavernous angioma: a practical review of clinical and biological aspects.  Surg Neurol. 2005;  63 319-328
• 31 Campeau N G, Lane J I. De novo development of a lesion with the appearance of a cavernous malformation adjacent to an existing developmental venous anomaly.  AJNR Am J Neuroradiol. 2005;  26 156-159
• 32 Maeder P, Gudinchet F, Meuli R, de Tribolet N. Development of a cavernous malformation of the brain.  AJNR Am J Neuroradiol. 1998;  19 1141-1143
• 33 Porter R W, Detwiler P W, Spetzler R F et al.. Cavernous malformations of the brainstem: experience with 100 patients.  J Neurosurg. 1999;  90 50-58
• 34 Wilms G, Bleus E, Demaerel P et al.. Simultaneous occurrence of developmental venous anomalies and cavernous angiomas.  AJNR Am J Neuroradiol. 1994;  15 1247-1254
• 35 Nomura S, Kato S, Ishihara H et al.. Association of intra- and extradural developmental venous anomalies, so-called venous angioma and sinus pericranii.  Childs Nerv Syst. 2006;  22 428-431
• 36 Lasjaunias P, Burrows P, Planet C. Developmental venous anomalies (DVA): the so-called venous angioma.  Neurosurg Rev. 1986;  9 233-242
• 37 Riel-Romero R M, Mattingly M. Developmental venous anomaly in association with neuromigrational anomalies.  Pediatr Neurol. 2005;  32 53-55
• 38 Peebles T R, Vieco P T. Intracranial developmental venous anomalies: diagnosis using CT angiography.  J Comput Assist Tomogr. 1997;  21 582-586
• 39 Abe T, Singer R J, Marks M P et al.. Coexistence of occult vascular malformations and developmental venous anomalies in the central nervous system: MR evaluation.  AJNR Am J Neuroradiol. 1998;  19 51-57
• 40 Dudeck O, van Velthoven V, Schumacher M, Klisch J. Development of a complex dural arteriovenous fistula next to a cerebellar developmental venous anomaly after resection of a brainstem cavernoma. Case report and review of the literature.  J Neurosurg. 2004;  100 335-339
• 41 Raybaud C A, Strother C M, Hald J K. Aneurysms of the vein of Galen: embryonic considerations and anatomical features relating to the pathogenesis of the malformation.  Neuroradiology. 1989;  31 109-128
• 42 Lasjaunias P L, Chng S M, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R. The management of vein of Galen aneurysmal malformations.  Neurosurgery. 2006;  59 S3-184-S3-194
• 43 Nikas D C, Proctor M R, Scott R M. Spontaneous thrombosis of vein of Galen aneurysmal malformation.  Pediatr Neurosurg. 1999;  31 33-39
• 44 Lee R R, Becher M W, Benson M L, Rigamonti D. Brain capillary telangiectasia: MR imaging appearance and clinicohistopathologic findings.  Radiology. 1997;  205 797-805
• 45 Castillo M, Morrison T, Shaw J A, Bouldin T W. MR imaging and histologic features of capillary telangiectasia of the basal ganglia.  AJNR Am J Neuroradiol. 2001;  22 1553-1555
• 46 Yoshida Y, Terae S, Kudo K et al.. Capillary telangiectasia of the brain stem diagnosed by susceptibility-weighted imaging.  J Comput Assist Tomogr. 2006;  30 980-982
• 47 Wanebo J E, Lonser R R, Glenn G M, Oldfield E H. The natural history of hemangioblastomas of the central nervous system in patients with von Hippel-Lindau disease.  J Neurosurg. 2003;  98 82-94
• 48 Glasker S, Van Velthoven V. Risk of hemorrhage in hemangioblastomas of the central nervous system.  Neurosurgery. 2005;  57 71-76
• 49 Choyke P L, Glenn G M, Walther M M et al.. von Hippel-Lindau disease: genetic, clinical, and imaging features.  Radiology. 1995;  194 629-642
• 50 Lee S R, Sanches J, Mark A S et al.. Posterior fossa hemangioblastomas: MR imaging.  Radiology. 1989;  171 463-468
• 51 Quadery F A, Okamoto K. Diffusion-weighted MRI of haemangioblastomas and other cerebellar tumours.  Neuroradiology. 2003;  45 212-219