Cerebral Proliferative Angiopathy | Figure 1

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Cerebral Proliferative Angiopathy

Axial CT (image 1) shows a parenchymal hemorrhage (arrow) within the right parietal lobe. Subsequent axial contrast-enhanced CT (image 2 and 3) show innumerable blood vessels within the right parietal lobe. Digital subtraction angiography (Image 4) highlights the vascular anomaly consistent with cerebral proliferative angiopathy. Cerebral proliferative angiopathy is a vascular lesion with diffuse intravascular shunting. It is differentiated from an arteriovenous malformation by normal intervening brain parenchyma.

Similar cases

Coronal (image 1) and axial (image 2) CT show herniation of a gyrus (arrow) through a remote right parietal skull fracture, which is further highlighted on a 3D reformatted image (image 3). Gyrus herniation can lead to a growing skull fracture, also known as a leptomeningeal cyst. These fractures occur in young children.

Axial T1 FLAIR (image 1), T2 (image 2), FLAIR (image 3), and T1 post-contrast (image 4) MRI show a cavernous malformation (arrow) in the right temporal lobe. The lesion exhibits heterogeneous T1 signal and minimal enhancement, with a characteristic hypointense rim on T2 and FLAIR due to mild hemorrhage. Most patients with a cavernous malformation are asymptomatic but can present with headaches, seizures, or focal deficits if hemorrhage occurs.

Axial CT of the head (image 1) shows focal calcification (arrow) in the right temporal lobe. Axial FLAIR (image 2), T2 weighted (image 3), and T1 weighted postcontrast (image 4) MRI shows abnormal signal within the subcortical white matter of the posterior aspect of the superior right temporal gyrus consistent with focal cortical dysplasia. Focal cortical dysplasia is one of the most common causes of refractory epilepsy.

Axial (image 1) and sagittal (image 2) head CT show no brain parenchyma within the anterior or middle cerebral artery distribution. The falx cerebra is present. Sagittal T2 weighted MRI (image 3) highlights minimal residual brain parenchyma in the posterior cerebral distribution. The brainstem and cerebellum are also present. Hydranencephaly is caused by in utero bilateral internal carotid artery obstruction causing infarction of the brain in the middle and anterior cerebral artery blood flow distribution.