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Intracranial Vascular Malformations

Imaging and Management

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Clinical Neuroradiology

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Abstract

Intracranial vascular malformations (ICVM) belong to a group of complex vascular lesions, which have different etiologies, physiopathology, and clinical behaviors, may cause intracranial haemorrhage and stroke, and need to be considered in the differential diagnosis of intracranial tumors, inflammation, and developmental disease. Clinical neuroradiology plays an important role in differentiating the individual vascular pathology and in providing endovascular treatment. Angiography can classify intracranial vascular malformations according to their appearance and differentiate malformations with and without arteriovenous shunts. Intracranial vascular malformations without arteriovenous shunt are brain capillary telangiectasia, development venous anomaly, and cerebral cavernous malformation. Intracranial vascular malformations with arteriovenous shunt are brain arteriovenous malformation and dural arteriovenous malformation. Noninvasive radiological techniques like CT/CTA and MR/MRA allow most of the time the accurate diagnosis of these malformations and the evaluation of former intracranial haemorrhages and coexisting brain edema. Digital subtraction angiography is necessary to assess the flow dynamics, detect small arteriovenous shunts, and decide about the indication and technique of endovascular treatment.

This publication is endorsed by: European Society of Neuroradiology (www.esnr.org).

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Abbreviations

BAVM:

Brain arteriovenous malformation

BCT:

Brain capillary telangiectasia

bFGF:

Basic fibroblast growth factor

CCM:

Cerebral cavernous malformation

CECT:

Contrast-enhanced computerized tomography

CPA:

Cerebral proliferative angiopathy

CT(A):

Computerized tomography (angiography)

DAVF:

Dural arteriovenous fistula

DSA:

Digital subtraction angiography

DVA:

Development venous anomaly

FLAIR:

Fluid-attenuated inversion recovery

GAD:

Gadolinium

GRE:

Gradient echo

HR:

Hazard ratio

ICVM:

Intracranial vascular malformation

MRTOF:

Magnetic resonance time of flight

MR(A):

Magnetic resonance (angiography)

MRI:

Magnetic resonance imaging

NCCT:

No contrast computerized tomography

PICA:

Posterior inferior cerebellar artery

SAH:

Subarachnoid haemorrhage

SWI:

Susceptibility-weighted imaging

T1WI:

T1-weighted image

T2WI:

T2-weighted image

TIA:

Transitory ischemic attack

VFGF:

Vascular endothelial growth factor

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  • Reynolds MR, Lanzino G, Zipfel GJ. Intracranial dural arteriovenous fistulae. Stroke. 2017;48:1424–31.

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Author information

Authors and Affiliations

  1. Neuroradiology Department, University Hospital Santa Maria, Lisbon, Portugal

    Luisa Biscoito

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  1. Luisa Biscoito
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Correspondence to Luisa Biscoito .

Editor information

Editors and Affiliations

  1. Department of Radiology and Nuclear Medicine, VU University Medical Centre (VUmc), Amsterdam, The Netherlands

    Frederik Barkhof

  2. The National Hospital for Neurology and Neurosurgery and University College Hospital (UCH), UCL Institute of Neurology, London, UK

    Hans Rolf Jäger

  3. Section of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy, University Hospital Vienna, Vienna, Austria

    Majda M. Thurnher

  4. Department of Radiology and Nuclear Medicine Vall d’Hebron University Hospital Professor of Radiology and Neuroimmunology, Autonomous University of Barcelona Vall d’Hebron Research Institute (VHIR), Barcelona, Spain

    Àlex Rovira

Section Editor information

  1. Institut und Poliklinik für Neuroradiologie, Universitätsklinikum Carl Gustav Carus, Dresden, Dresden, Saxonia, Germany

    Rüdiger von Kummer

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Biscoito, L. (2019). Intracranial Vascular Malformations. In: Barkhof, F., Jäger, H., Thurnher, M., Rovira, À. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-68536-6_79

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  • DOI: https://doi.org/10.1007/978-3-319-68536-6_79

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68535-9

  • Online ISBN: 978-3-319-68536-6

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