# July 2022

- Link: https://isnr.in/july-2022/
- Published: 2022-07-02T10:47:24+05:30
- Author: ISNR

##  July 2022

**CASE HISTORY**:

23 year old lady with tingling  numbness in the right upper limb

No focal deficits

No significant past history

No neurological deficits on examination

MRI BRAIN (P+C) done for further evaluation

## **Case contributed by –**

Dr.Ganesh Shetty B

Dr.Lakshmikanth G N

Dr. Prakash P Iyer

Dr. Chaithra P Adiga 

Department of Radiology, Apollo hospital, Sheshadripurum: Bangalore     

| [⌊July22_A⌉](https://isnr.in/wp-content/uploads/2022/07/July22_A.jpg) | [⌊July22_B⌉](https://isnr.in/wp-content/uploads/2022/07/July22_B.jpg) | [⌊July22_C⌉](https://isnr.in/wp-content/uploads/2022/07/July22_C.jpg) | [⌊July22_D⌉](https://isnr.in/wp-content/uploads/2022/07/July22_D.jpg) | 
| [⌊July22_E⌉](https://isnr.in/wp-content/uploads/2022/07/July22_E.jpg) | [⌊July22_F⌉](https://isnr.in/wp-content/uploads/2022/07/July22_F.jpg) | [⌊July22_G⌉](https://isnr.in/wp-content/uploads/2022/07/July22_G.jpg) | [⌊July22_H⌉](https://isnr.in/wp-content/uploads/2022/07/July22_H.jpg) |

| [⌊15July22-1⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-1.jpg) | [⌊15July22-2⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-2.jpg) | [⌊15July22-3⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-3.jpg) | [⌊15July22-4⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-4.jpg) | 
| [⌊15July22-5⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-5.jpg) | [⌊15July22-6⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-6.jpg) | [⌊15July22-7⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-7.jpg) | [⌊15July22-8⌉](https://isnr.in/wp-content/uploads/2022/07/15July22-8.jpg) | 
|  |  |  |  |

No abnormality seen in plain CT (A) and DWI (B) images. Rounded hyperintense area
seen in left  half of rostral midbrain in axial T2 weighted image (C) with corresponding
hypointensity in SWI image (D). Pre contrast T1(E) shows small hypointense area.
Post contrast axial (F), coronal (G) and sag (H) T1 images show stippled enhancement
with draining vein (yellow arrows)

## **DIAGNOSIS: Capillary telangiectasias**

•Mostly located in the brainstem (most commonly in the pons) (1)

•Often solitary and rarely can be multiple (1)

•Usually not seen on CT  or catheter angiography (DSA)

•T1 may be iso to hypo and subtle bright on T2/FLAIR

•T2*GRE /SWI: Shows low signal intensity due to deoxyhemoglobin from sluggish flow
and not due to bleed or mineralisation (2)

•Post contrast T1WI, may demonstrate stippled enhancement

•If large, can show branching/linear draining veins (3)

•No touch lesion & no follow-up is required if the imaging appearances are characteristic

## REFERENCES

1.Castillo M, Morrison T, Shaw JA et-al. MR imaging and histologic features of capillary
telangiectasia of the basal ganglia. AJNR Am J Neuroradiol. 2001;22 (8): 1553-5.
AJNR Am J Neuroradiol

2.R R Lee et.al, Brain capillary telangiectasia: MR imaging appearance and clinicohistopathologic
findings, December 1997 Radiology, 205, 797-805.

3.Auffray-Calvier E, Desal HA, Freund P, Laplaud D, Mathon G, de Kersaint-Gilly 
A. Capillary telangiectasias: angiographically occult vascular malformations—MRI
symptomalogy apropos of 7 cases. J Neuroradiol 1999;26:257-261