The diagnosis of vascular micromalformations in the brain

Ninety cases with cerebrovascular micro-malformations were analyzed. These abnormalities amount to 5.3% of the total number of patients with arteriovenous malformation. These include various vascular defects from 0.5 to 1.0 cm. Most of them run as strokes (80%); the others have a pseudotumorous course. Angiography reveals 60.5% of cerebrovascular micro-malformations. In other cases they are undetectable or their identification requires functional and gross angiography. Computed tomography and magnetic resonance tomography reveal intracranial hemorrhages from cerebrovascular micro-malformations, without identifying the latter. They cannot differentiate a tumor from parenchymatous hemorrhages from cerebrovascular micro-malformations in 37.7%. The greater diagnostic difficulties arise in subtentorial cerebrovascular micro-malformations having a pseudotumorous course. In these cases they are angiographically invisible, and CT (MRT) diagnosis prior to surgery is a volumetric brain formation, providing no specification of the process.