Clinical Manifestations And Imaging Features Of Cerebral Cavernous Angioma

Objective:To analysis clinical manifestations and imaging features of cerebral cavernous angioma.Methods:Collected and studied the clinical manifestations and CT,MRI,DSA data of cerebral cavernous angioma of patients,which confirmed by neurology and neurosurgery.All the patients were admitted by the Second Affiliated Hospital of Dalian Medical University from May 2002 to March 2010.After induction,classified according to the clinical manifestations combined with its imaging features to analysis.Results:Clinical manifestations1.Asymptomatic and non-specific symptoms:headache and dizziness in 4 cases.1 lesion in the left frontal lobe,parietal lobe junction,1 in right occipital lobe,1 in right mesencephalon,l in right insular lobe.3 cases discovered incidentally on examination,1 in right temporal lobe,occipital junction,1 in left temporal lobe,occipital lobe junction,1 in left cerebellum.2.Epilepsy:epilepsy in 3 cases,generalized seizures in 2 cases,focal seizures evolving into full seizures in 1 cases.2 cases less than 15 years old,all male.The lesion in the left temporal lobe showed focal seizures evolving into full seizures.The multiple lesions in the left temporal lobe,occipital lobe junction and right occipital lobe showed generalized seizures.The other was female,49 years old,the lesion in the left frontal lobe showed generalized seizures.3.Hemorrhage:4 cases were hemorrhage on CT,3 patients showed vertigo,1 in left pons,the others in right cerebellum.1 patient showed partial body sensory disturbances,the lesion in right pons.4.Focal neurological deficits:1 patient showed right lower limb weakness and numbness,the lesion in the left insular.1 patient showed paroxysmal blurred vision,the lesion in left pons.Imaging1.11 cases were examined by CT,9 lesions showed higher density,2 lesions showed uneven density.4 lesions companied with hemorrage showed higher density.The lesions in brain stem vary in size from 0.8cm to 1.5cm,in the other lobes from 0.2cm to 4.0cm.2.15 cases were examined by MRI.On T1WI,5 lesions displayed mixed signal,6 lesions displayed high-intense signal,3 lesions displayed low-signal,1 lesion displayed isointense signal.On T2WI,5 lesions displayed high-intense signal,5 lesions displayed high-intense signal,5 lesions displayed mixed signal,neither perifocal edema nor spaceoccupying effect was present in all cases. After administration of contrast media,5 lesions had no enhancement and 3 lesions slight enhancement.11 lesions displayed ring-like low-signal on T2WI.3.DSA 5 cases examined by DSA,all lesions showed no abnormal.Conclusion:Cerebral cavernous angioma occur in the 20-50-year-old,many located in the supratentorial with clear border,and often companied with calcification and hemorrhage.Cerebral angiography(DSA and MRA)is negative for CCA,The lesion can be found by CT,but lack of specificity and sensitivity.MRI is more sensitive and specific for CCA.The lesion's features displayed mixed signal and ring-like low-signal on T2WI.In the aspects of settling sex diagnosis to examine CCA obvious better than CT of MRI.Seizures,repeated hemorrhage and headache were the respective main presentation of CCA.Many located in the supratentorial showed Seizures, many located in the infratentorial showed focal neurological deficits.Its diagnosis can be combined with imaging,the prognosis was favourable.