Neurology India Medknow Publications on behalf of the Neurological Society of India ISSN: 0028-3886 EISSN: 1998-4022 Vol. 58, Num. 4, 2010, pp. 618-619

Neurology India, Vol. 58, No. 4, July-August, 2010, pp. 618-619

Topic of the Issue: Neuroimage

Susceptibility-weighted imaging in capillary telangiectasia

Pendharkar HimaS, Thomas Bejoy, Gupta ArunKumar

Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum-695 011, Kerala

Correspondence Address:Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, Kerala, himasp@hotmail.com

Date of Acceptance: 01-Jan-2010
Date of Print Publicaton: 23-Aug-2010

Code Number: ni10162

PMID: 20739806

DOI: 10.4103/0028-3886.68671

A 54-year old female presented with acute onset of dysphagia with nasal regurgitation and dysarthria of two weeks duration. She had in addition vertigo with tinnitus in the right ear since six months and mild weakness of the right hand grip since six weeks. On examination, there was mild left ptosis with gaze evoked nystagmus. Pain, temperature, vibration and position sense were impaired on the right face. Right ninth and tenth cranial nerves were also involved. There was mild spasticity in the right upper and lower limbs, grade 4+/5 power and brisk deep tendon reflexes. Right cerebellar signs were positive in the upper limb. Magnetic resonance imaging (MRI) of the brain revealed a left medullary cavernoma [Figure - 1]a-d with pontine capillary telangiectasia [Figure - 2]a and b.

Capillary telangiectasias (CT) are clinically asymptomatic lesions, commonly located in the pons. ^[1] On T2-weighted image it appears as fluffy hyper intensities, while on contrast enhanced T1-weighted image it is seen characteristically as a bunch of small vessels converging on a collector vein. ^[2] Susceptibility weighted image (SWI), however, demonstrates CT exquisitely without the need for contrast. ^[3] It also demonstrates cavernous malformation (CM) as areas of profound blooming. Identification of CT on SWI promotes to look for a coexistent CM or a developmental venous anomaly which is responsible for the symptoms of the patient. Our image adds to the limited literature on SWI features in CT. ^[4] SWI sequence should be incorporated in routine MR imaging to avoid the cost of contrast and also save the imaging time, without compromising diagnostic efficacy in any way.

Acknowledgment

The authors wish to thank the Director, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India for his kind permission in bringing out this report.

References

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