Author: Thomas J. Ward
NECT CECT MRI - T1 MRI - T2 MRI - T1 post-contrast Digital Subtraction Angiography
Cerebral Arteriovenous Malformation (AVM) mostly present as an acute bleed, possibly as calcifications strong enhancement, dilated vesels hemorrhage, flow voids, feeding artery, nidus, and draining vein hemorrhage, flow voids, feeding artery, nidus, and draining vein strong enhancement, feeding artery, nidus, and draining vein dilated feeding artery, nidus (possibly compressed by hematoma), and early draining vein
Arteriovenous Fistula dilated vascular channels, possibly with calcifications tortuous vessel, often to dural sinus flow voids, possibly with thrombosed dural sinus flow voids, possivly with thrombosed dural sinus or hyperintense adjacent brain reformatted MRA demonstrates dilated tortuous vessel draining into sinus without nidus fistula between branch of ECA and dural sinus is most common, may see outflow stenosis
Developmental Venous Anomaly often see dilated vein, may only see calcification enlarged drainaing vein, no nidus possibly normal, possibly with flow void   possibly with flow void, blood products   dilated vein drains into dural sinus/ependymal vein usually normal on arterial and capillary phase with dilated draining vein, "Medusa Head" seen on more delayed phase
   
Glomus Jugulare soft tissue mass expanding jugular foramen diffuse enhancement intense, possibly with "salt and pepper" appearance related to blood products intense, possibly with "salt and pepper" appearance related to blood products avid enhancement Hypervascular mass with enlarged feeding arteries, rapid, intense tumor blush & early draining veins  
   
Hemangioma well-defined soft tissue mass   prominent enhancement circumscribed isointense mass iso- to hyperintnese circumscribed mass avid enhancement confirms vascular nature
   
Sturge-Weber cerebral volume loss, calcifications choroid plexus enlargement (arrow), volume loss volume loss   volume loss, hyperintense signal may be seen in areas of gliosis leptomeningeal enhancement pial blush, numerous medullary and deep collaterals
   
Aneurysm often presents as subarachnoid hemorrhage, may present as calcified mass saccular or fusiform vessel dilitation, often multiple aneurysms are identified flow voids or heterogeneous signal related to slow flow, possibly thrombus typically demonstrate flow voids fusiform or saccular vessel dilation, less sensitive than CTA Active extravasation is rarely seen, bilateral ICA and vertebral injections need to be performed to evaluate for multiple aneurysms