Cerebral Proliferative Angiopathy: Differentiation from Arteriovenous Malformation (AVM)
An 18-year-old male presented with recurrent headaches and two episodes of seizures. On examination, he had no neurological deficits. Contrast-enhanced CT scan of brain revealed a markedly enhancing lesion in right frontal region (Fig. 78.1a, b). No mass effect was seen. MRI revealed a diffuse network of flow voids in parenchymal and subarachnoid space (Fig. 78.1c–f). The dilated vascular spaces seemed to be interspersed with normal brain parenchyma. DSA was performed which revealed a densely enhancing vascular spaces in the frontal region (Fig. 78.2a–d). The arteries in the region were mildly dilated, but no dominant feeder could be seen. There was early venous filling, but relative to the size of the lesion, veins were few and mildly dilated. No evidence of any arteriovenous fistula was seen.