Abstract
We have experienced ten cases of angiographically occult cerebral angiomas (AOA).
The mean age of the patients was 26 years old. There was no sex difference in the prevalence. Symptoms consisted of convulsion in seven cases, and headache, hemianopsia and motor weakness in each case.
CT showed high density lesions in nine cases. One patient has a punctate calcified mass, and positive contrast enhancements were seen in five patients. MRI was performed in three cases. MRI was useful in detecting subacute and chronic hematoma which revealed high signal intensity in T1 and T2-weighted-image and hemosiderin with low signal intensity in T2 image. All angiomas were extirpated by open surgery. There were two transient neurological deficits and one permanent deficit (homonymous hemianopsia). The angiomas consisted of five arteriovenous malformations, four cavernous angiomas and one unclassified angioma. Histological examinations showed acute or old hemorrhage with hemosiderin deposition in all specimens. AOAs cause macroscopic and subclinical hemorrhages. It is important to differentiate AOA from brain tumor because these lesions sometimes appear similar in CT and MRI.
Therefore, surgically accessible AOAs should be extirpated by meticulous microsurgical technique.
