Intracranial Aneurysms and Vascular Malformations: Imaging Findings and Clinical Considerations

Intracranial vascular malformations can be classified as either acquired or congenital lesions. Acquired lesions include intracranial aneurysms, dural arteriovenous fistulae, and caroticocavernous fistulae. Congenital lesions include intracranial arteriovenous malformations and cerebral cavernous malformations. All of these lesions are of clinical significance given their ability to both bleed and produce various neurological deficits. Increasing use of CT and MR imaging modalities for the evaluation of mild or vague neurological complaints has resulted in increases in incidental detection rates for many of these lesions. It is therefore important that radiologists understand how to accurately identify and characterize these lesions on noninvasive imaging. In this chapter, we present pertinent clinical background information on these intracranial vascular lesions, review the significance of different morphological and anatomic features that can be readily identified on CTA/MRA, and discuss what pieces of information need to be succinctly conveyed to referring medical providers to ensure appropriate patient care.