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Iran J Neurosurg 2025, 11 - Continuous Publishing: 0-0 |
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Ghorbani M, Hasanpoor M, Mirsardoo H, Jafari S, Ghasemigeskeminjan F, Shams Amiri R. Non-hypertensive Spontaneous Intracerebral Hemorrhage, Case Report for Additional Value of Cone Beam Computed Tomography Angiography in Better Diagnosis and Endovascular Management. Iran J Neurosurg 2025; 11 : 9
URL: http://irjns.org/article-1-452-en.html
URL: http://irjns.org/article-1-452-en.html
Mohammad Ghorbani1 
, Mohammad Hasanpoor1 , Hojjat Mirsardoo2 , Seifollah Jafari3 , Fakhrialsadat Ghasemigeskeminjan3 , Rouzbeh Shams Amiri *4
, Mohammad Hasanpoor1 , Hojjat Mirsardoo2 , Seifollah Jafari3 , Fakhrialsadat Ghasemigeskeminjan3 , Rouzbeh Shams Amiri *4
1- Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Hojjat, Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, Iran.
3- Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
4- Department of Neurological Surgery, Neuroscience Research Center, Golestan University of Medical Sciences. Gorgan, Iran. ,rshamsa@gmail.com
2- Hojjat, Department of Neurosurgery, Kerman University of Medical Sciences, Kerman, Iran.
3- Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
4- Department of Neurological Surgery, Neuroscience Research Center, Golestan University of Medical Sciences. Gorgan, Iran. ,
Abstract: (9 Views)
Background and Importance: Cerebral micro-arteriovenous malformations (micro-AVMs), defined as occult nidus smaller than 1 cm, pose diagnostic challenges on conventional imaging and complicate treatment due to their small size and risk of hemorrhage. Advanced imaging modalities, such as intra-arterial cone-beam computed tomography angiography (CBCT-A), have shown promise in enhancing diagnostic accuracy and treatment planning.
Case Presentation: We report the case of a 58-year-old woman who presented with intracerebral hemorrhage (ICH) without a history of hypertension. Initial computed tomography (CT) and magnetic resonance imaging (MRI) failed to identify the underlying vascular anomaly, necessitating catheter-based intra-arterial digital subtraction angiography (DSA), which revealed a small, low-flow nidus indicative of an AVM. Selective CBCT-A provided a detailed angioarchitectural evaluation, enabling precise catheterization and effective nidus occlusion with Onyx 18.
Conclusion: This case highlights the critical role of combining digital subtraction angiography (DSA) and CBCT-A in the management of AVMs, particularly when traditional imaging is inconclusive. These modalities are crucial for managing AVMs, especially in patients with atypical presentations or those without common cerebrovascular risk factors.
Case Presentation: We report the case of a 58-year-old woman who presented with intracerebral hemorrhage (ICH) without a history of hypertension. Initial computed tomography (CT) and magnetic resonance imaging (MRI) failed to identify the underlying vascular anomaly, necessitating catheter-based intra-arterial digital subtraction angiography (DSA), which revealed a small, low-flow nidus indicative of an AVM. Selective CBCT-A provided a detailed angioarchitectural evaluation, enabling precise catheterization and effective nidus occlusion with Onyx 18.
Conclusion: This case highlights the critical role of combining digital subtraction angiography (DSA) and CBCT-A in the management of AVMs, particularly when traditional imaging is inconclusive. These modalities are crucial for managing AVMs, especially in patients with atypical presentations or those without common cerebrovascular risk factors.
Article number: 9
Keywords: Cone-beam computed tomography (CBCT), Intracranial arteriovenous malformations (AVMs), Endovascular procedures
Type of Study: Case report |
Subject:
Functional Neurosurgery
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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