Atlas of Nervous System Vascular Malformations: A Systematic Review

Abstract

Vascular malformations are frequent in the head and neck region, affecting the nervous system. The wide range of therapeutic approaches demand the correct anatomical, morphological, and functional characterization of these lesions supported by imaging. Using a systematic search protocol in PubMed, Google Scholar, Ebsco, Redalyc, and SciELO, the authors extracted clinical studies, review articles, book chapters, and case reports that provided information about vascular cerebral malformations, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 385,614 articles were grouped; using the inclusion and exclusion criteria, three of the authors independently selected 51 articles about five vascular cerebral malformations: venous malformation, brain capillary telangiectasia, brain cavernous angiomas, arteriovenous malformation, and leptomeningeal angiomatosis as part of Sturge–Weber syndrome. We described the next topics—“definition”, “etiology”, “pathophysiology”, and “treatment”—with a focus on the relationship with the imaging approach. We concluded that the correct anatomical, morphological, and functional characterization of cerebral vascular malformations by means of various imaging studies is highly relevant in determining the therapeutic approach, and that new lines of therapeutic approaches continue to depend on the imaging evaluation of these lesions.

Histological changes of vascular clipping in Wistar rats

“…e peak age when presented corresponds to 40-60 years of age, with a slight preference for the female gender, 3:1. [2,3,8,12,14] ere are two types of treatments for brain aneurysms: endovascular or microsurgical treatment. e aim of microsurgery is to exclude the aneurysmal sac from circulation by placing one or more clips at the base of the aneurysm.…”

“…The peak age when presented corresponds to 40–60 years of age, with a slight preference for the female gender, 3:1. [ 2 , 3 , 8 , 12 , 14 ]…”

Coexistence of brain capillary telangiectasia and venous angioma: A case report and literature review

“…17 BCT appears as isointense lesions with elevated edges. 17 While T1 and T2 images may appear normal, images taken post-contrast in T1 may show a capitation in a pointed form or "brush" pattern that is characteristic of BCT. It can appear as an isolated lesion with a dotted appearance or as multiple dotted foci.…”

“…16 MRI with gadolinium contrast is the diagnostic modality of choice, which can differentiate BCT from other vascular anomalies, particularly cavernous angiomas, which can be diagnostically similar. 17 BCT appears as isointense lesions with elevated edges. 17 While T1 and T2 images may appear normal, images taken post-contrast in T1 may show a capitation in a pointed form or "brush" pattern that is characteristic of BCT.…”

“…16,17 Conservative management is typically preferred in most cases of BCT given its benign nature and extremely low risk of bleeding and disease progression. 5,17 However, in minority of patients, both surgical intervention and endovascular treatment are recommended and equally appropriate approaches. 17 In conclusion, BCT can be asymptomatic and manifest with variable neurological symptoms as well.…”