Diagnosis:
Clinical:
- Usually an incidental finding, very rarely [case reports] of bleeding.
MRI:
- Pons
- ~3cm diameter
- T1 +contrast: Nodular enhancement after contrast
- Gradient echo GRE: hypointense,
- T2 isointense
CT: invisible
Angiography:
- Usually nothing is visible
Pathology:
- Pons is the commonest location
- Microscopic Ectatic thin walled vascular channels (Capillaries) with interspersed normal appearing brain matter. Usually, no surrounding blood products, but hemosiderin has been reported.
- Rarely associated with Hereditary hemorrhagic telangiectasia a.k.a. Osler-Weber-Rendu disease
Treatment:
- No treatment is necessary, this is a normal variant
- Avoid surgery or radiation therapy, this will lead to complications
- Clinical relevance: easily confused with small enhancing lesions