Abstract
Three case of brainstem vascular malformation were reported. Case 1, 32 year-old man, presented with left-sided ptosis and mild right hemiparesis, was clinically diagnosed to have Weber's syndrome. Vertebral angiography showed medullary veins with a medusa like pattern and computed tomography (CT) demonstrated a ring-like high density in the left cerebral peduncle and left thalamus. This case was considered to have a venous angioma of the midbrain and the thalamus neuroradiologically. Case 2, 58 year-old woman, and case 3, 53 year-old woman, were thought to have been multiple sclerosis (MS) at some time in their courses because of their progressive and intermittent clinical courses. Vertebral angiography of case 2 showed large draining veins in the dorsal aspect of the pons. CT scan demonstrated an enhansing round density area without a mass effect in the pons. The lesion was suggestive of a venous angioma. Vertebral angiography of case 3 showed no abnormal findings. However, CT scan showed an enhansing nodular density area in the right side of the pons and the medulla oblongata. The lesion was also suggestive to be a vascular malformation. The patients with the progressive and intermittent neurological signs and symptoms due to brainstem vascular malformation can be quite difficult to differentiate from other diseases such as MS, brainstem glioma or brainstem encephalitis. It is stressed that the patients with these kinds of clinical history should be carefully examined neurologically and neuroradiologically.
