| Vol. 3, Issue 1, Article 3 |
|
Mironov |
CT image (Fig 1), MR T 2 - weighted image (Fig 2) and Diffusion weighted imaging (Fig 3) reveal a circumscribed and not typical acute ischemic damage of upper right cerebellum.
The angiography of vertebrobasilar system (Fig 4,5,6,7) and the selective injection of right superior cerebellar artery (Fig 8,9,10,11) show an area in right upper cerebellum with blush related enhancement detected in early arterial phase and increasing progressively during the parenchymal phase (arrows).
The venous phase presents many atypical cortical venous structures, like a "caput medusae", with large sample vein compatible with appearance of a developmental venous malformation. Especially the early lateral venous phase of selective right superior cerebellar angiogram (Fig 10) shows dichotomically divided venous channels while the late venous phase of same projection show normal venous structures only (Fig 11).
MR imaging 1 week follow-up (Fig 12,13) demonstrates regress of edematous lesion, and MR imaging 5 months follow-up (Fig 14) shows almost complete reversal of parenchymal damage.
The ischemic lesion was generated within the framework of an existing developmental venous malformation, probably because of thrombotic affection of drainage vein. Therefore, the follow up MR imaging show nearly complete reversal of venous parenchymal damage.
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