COMPUTERIZED TOMOGRAPHY FINDINGS IN ARTERIOVENOUS-MALFORMATIONS OF THE BRAIN

Computerized tomography (CT) scans of 54 patients with an arteriovenous malformation (AVM) of the brain were reviewed. The 31 males and 23 females (mean age: 33 yr) were classified according to clinical presentation: (1) intracranial hemorrhage (30 patients); (2) seizure disorder (19 patients); and (3) other neurological disturbance (5 patients). A brain hematoma was identified in all of the patients in the hemorrhagic group having a CT scan within 1 wk of the bleed. Extension of hemorrhage into the ventricular system as seen in 8 cases was invariably accompanied by severe neurological dysfunction. A high-density lesion without associated mass effect was found in 48% of patients presenting with a seizure disorder. Dilatation of the ipsilateral lateral ventricle, a common finding in this group of patients, was thought to indicate an atrophic process. Evidence of discrete brain infarction was unusual. Intravenous infusion with Hypaque provided additional information in 31 of the 35 patients so studied. Demonstration of prominent or enlarged feeding arteries and/or draining veins occurred in 20% of patients with large malformations. Six cases of angiographically occult AVM's were found. A correlation of the CT scan with clinical, angiographic, and histological findings is presented.