bubble_chart Overview

Cerebrovascular malformation, also known as angioma, is not a true tumor but rather a congenital developmental abnormality of cerebral blood vessels. Clinically, it presents in various types, with arteriovenous malformation being the most common. Based on the diameter of the malformed vascular mass, clinical classifications include large, medium, and small lesions. This condition is more prevalent in males and is commonly seen in young adults. The most frequent clinical manifestation is rupture and bleeding of the malformed vessels, while some patients may present with epilepsy as the initial symptom. Due to the "steal" phenomenon, localized cerebral ischemia can lead to brain atrophy, intellectual decline, and possible mental abnormalities. Severe bleeding may cause brain herniation, which can be fatal if not treated promptly. There are multiple treatment approaches for this condition, with surgical removal of the lesion being the most ideal. Endovascular interventional therapy and gamma knife treatment represent novel therapeutic methods.

bubble_chart Clinical Manifestations

1. General symptoms: Pulsatile headache, located on the affected side, may be accompanied by intracranial vascular murmurs.
2. Hemorrhage: Often the first symptom, manifested as subarachnoid hemorrhage or intracerebral hematoma.
3. Epilepsy: May be the first symptom or occur after hemorrhage, mostly generalized or focal seizures, with focal seizures having localizing significance.
4. Focal symptoms: Supratentorial lesions may present with psychiatric abnormalities, hemiplegia, aphasia, alexia, acalculia, etc. Infratentorial lesions often show vertigo, diplopia, nystagmus, and gait instability.

bubble_chart Diagnosis

1. Adolescent patient with a history of headache, epilepsy, and subarachnoid hemorrhage.
2. Clinical manifestations include acute spontaneous intracranial hemorrhage, epileptic seizures, or obvious focal signs.
3. Head CT: Non-contrast scans often show hypodense lesions with surrounding hypodensity; intracerebral hemorrhage may appear hyperdense. Post-contrast imaging reveals hyperdense vascular areas, sometimes displaying feeding arteries and draining veins.
4. Head MRI: Superior to CT, it not only visualizes malformed vessels and surrounding brain tissue but also differentiates hemorrhage from calcification. MR angiography improves the detection rate of vascular malformations.
5. Cerebral angiography: The most reliable and critical diagnostic method, demonstrating vascular clusters, feeding arteries, and early opacification of draining veins during the arterial phase.

bubble_chart Treatment Measures

1. Surgical treatment.
2. Endovascular interventional therapy.
3. Stereotactic radiosurgery (Gamma Knife, X-Knife).
4. Treatment of spontaneous hemorrhage.
5. Symptomatic treatment.

Expert advice: Cerebrovascular malformation is a congenital disease, often presenting with spontaneous hemorrhage or epilepsy as the initial symptoms. Therefore, young patients with similar medical histories should consider the possibility of this condition. Whether suspecting or confirming the disease, further diagnosis and treatment should be sought from a neurosurgeon. The occurrence of spontaneous hemorrhage is not proportional to the size of the malformed vascular mass. Hemorrhage can be fatal, but some patients may never experience bleeding in their lifetime. Currently, there are various treatment methods for cerebrovascular malformation, with endovascular interventional embolization of the malformed vessels combined with surgical treatment being the preferred approach. Small malformed vascular masses can be treated with embolization or Gamma Knife therapy alone, achieving good results. Patients should follow medical advice and avoid relying on hearsay.

bubble_chart Cure Criteria

1. Cure: After resection or embolization of the malformed blood vessels, there is no recurrence, symptoms disappear, and normal work and life are restored.
2. Improvement: Most of the malformed blood vessels are resected or embolized, and symptoms are alleviated.
3. No cure: The malformed blood vessels are not treated, and symptoms show no improvement.