E1932. Cerebral Vascular Pathology: Imaging and Latest Treatments Intravascular Treatments
Authors
Meagan Vaitses;
J. T. Mather Hospital, Northwell Health
Avraham Bluestone;
Stony Brook University Hospital
Background
Intracranial vascular lesions are relatively common and can cause significant neurologic disability or death. Neuroradiology plays a vital role in differentiating the individual vascular lesions and in providing endovascular treatment. Noninvasive CT/CTA and MRI/MRA allow for the accurate diagnosis of these malformations and associated hemorrhage or edema. Neuroangiography allows for the assessment of flow dynamics, detection of small shunts, and decide the course for endovascular treatment. This educational exhibit will review common vascular malformations both with high-flow and low-flow with or without arteriovenous shunting and discuss their modern treatment options.
Educational Goals / Teaching Points
This educational exhibit will review common vascular malformations both with high-flow and low-flow with or without arteriovenous shunting and discuss their modern treatment options. Specifically, we will present cases without shunting which include capillary telangiectasia, developmental venous anomaly, and cavernous malformation. Unless associated with hemorrhage, as a group, these are don’t touch lesions, and it is important to identify their specific features. Cases of intracranial vascular malformations with shunting will include arteriovenous malformation, and dural arteriovenous fistula. Finally, new treatment options for venous anomalies and sinus thrombosis, will be discussed.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Pertinent CT, CTA, MRI, MRA, and conventional angiographic findings will be used to illustrate the key anatomic and pathophysiologic issues related to the aforementioned vascular malformations.
Conclusion
This educational exhibit with help residents recognize and differentiate between the aforementioned types of vascular malformations. Residents will gain confidence in describing their appearance on CT/CTA, MRI/MRA, and conventional angiography. Gain knowledge on their subdivisions, common locations, and common associated pathologies. Become familiar with their Grading and Classifications systems of direct and in-direct carotid-cavernous fistulas. Gain experience in knowing the best next step in management, i.e., surveillance vs endovascular or surgical intervention. Finally, residents will be up to date on the latest endovascular treatment options.
