Cerebral varix associated with a venous angioma.

A 62-year-old woman was admitted to the hospital with aphasia and a right hemiplegia. Two weeks earlier she had been discharged after undergoing triple coronary artery bypass surgery. Her admission CT revealed an area of old ischemic infarction in the left basal ganglionic region, including portions of the caudate, lentiform nucleus, and the intemal capsule. An enhancing high-density lesion was also noted in the posterior aspect of the septum pellucidum near the foramen of Monro associated with en larged feeding and draining vessels (Fig . 1). At angiography, both carotid arterial phases were normal. The venous phase of the left carotid injection demonstrated a large venous angioma in the left frontal lobe. The vessels comprising the lesion all drained into an enlarged septal vein , which in tum drained directly into a cerebral varix located in the septum pellucidum (Fig . 2). The venous phase of the right carotid angiogram was normal. In particular, the right septal and internal cerebral veins were normal and demon­ strated no communication with the varix. The patient's hospital course was complicated by septicemia of unknown origin and a cardiac arrest, after which she became coma­ tose. Gradual recovery followed. It was decided that her intracranial angioma and varix were nonsurgical lesions, and she was subse­ quently discharged under conservative treatment.