Cavernous angioma overview: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
===History and Symptoms=== | |||
Clinical symptoms of this disease include recurrent [[headache]]s, focal neurological deficits, hemorrhagic [[stroke]], and [[seizures]], but CCM can also be [[asymptomatic]]. | |||
===MRI=== | ===MRI=== | ||
Diagnosis is most commonly made accidentally by routine [[magnetic resonance imaging]] (MRI) screening, but not all MRI exams are created equal. It is paramount that the patient request a gradient-echo sequence in order to unmask small or punctate lesions which may otherwise remain undetected. These lesions are also more conspicuous on FLAIR imaging compared to standard T2 weighing. FLAIR imaging is different from Gradient sequences, rather, it is similar to T2 weighing but suppresses free-flowing fluid signal. Sometimes quiescent CCMs can be revealed as incidental findings during MRI exams ordered for other reasons. | Diagnosis is most commonly made accidentally by routine [[magnetic resonance imaging]] (MRI) screening, but not all MRI exams are created equal. It is paramount that the patient request a gradient-echo sequence in order to unmask small or punctate lesions which may otherwise remain undetected. These lesions are also more conspicuous on FLAIR imaging compared to standard T2 weighing. FLAIR imaging is different from Gradient sequences, rather, it is similar to T2 weighing but suppresses free-flowing fluid signal. Sometimes quiescent CCMs can be revealed as incidental findings during MRI exams ordered for other reasons. | ||
Revision as of 17:36, 3 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Cavernous angioma, is a vascular disorder of the central nervous system that may appear either sporadically or exhibit autosomal dominant inheritance.
Epidemiology and Demographics
The incidence in the general population is between 0.1–0.5%, and clinical symptoms typically appear between 30 to 50 years of age. Once thought to be strictly congenital, these vascular lesions have been found to occur de novo.
Diagnosis
History and Symptoms
Clinical symptoms of this disease include recurrent headaches, focal neurological deficits, hemorrhagic stroke, and seizures, but CCM can also be asymptomatic.
MRI
Diagnosis is most commonly made accidentally by routine magnetic resonance imaging (MRI) screening, but not all MRI exams are created equal. It is paramount that the patient request a gradient-echo sequence in order to unmask small or punctate lesions which may otherwise remain undetected. These lesions are also more conspicuous on FLAIR imaging compared to standard T2 weighing. FLAIR imaging is different from Gradient sequences, rather, it is similar to T2 weighing but suppresses free-flowing fluid signal. Sometimes quiescent CCMs can be revealed as incidental findings during MRI exams ordered for other reasons.
MRA
Sometimes the lesion appearance imaged by MRI remains inconclusive. Consequently neurosurgeons will order a cerebral angiogram or magnetic resonance angiogram (MRA). Since CCMs are low flow lesions (they are hooked into the venous side of the circulatory system), they will be angiographically occult (invisible). If a lesion is discernible via angiogram in the same location as in the MRI, then an arteriovenous malformation (AVM) becomes the primary concern.