Testing & Diagnosis for Brain Cavernous Malformations in Children

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Before treating cavernous malformations (CMs), the care team will conduct a variety of specific neurologic tests to assess brain function, in addition to imaging tests.

At Boston Children's Hospital, we use magnetic resonance imaging (MRI) and computed tomography (CT) to diagnose and evaluate cavernous malformations. Unlike most other cerebrovascular conditions, cavernous malformations are difficult or impossible to see on angiograms, because the blood flow within the malformations is very slow and because the vessels feeding them are so tiny.

MRI produces 2- and 3-dimensional images of the head, neck and brain using a strong magnetic field, radio waves and advanced computer processing. It is noninvasive and uses no x-rays or radiation exposure of any kind.

  • The child must lie still inside an MRI scanner—a large, tube-shaped magnet—sometimes requiring her to be sedated. Sometimes a contrast dye is injected through an IV during scanning to get a better image.
  • In response to the magnetic field and the radio waves of the scanner, water molecules in the body give off tiny pulses of energy. A computer constructs detailed images out of these pulses, showing the head, neck an brain anatomy.
  • On MRI, cavernous malformations often have a very typical appearance, showing up distinctly from the surrounding brain tissue. The neuroradiologist often will be able to see areas of old and recent bleeding nearby.

CT uses x-ray equipment and powerful computers to create detailed, cross-sectional images (often called "slices") of the head, neck and brain. Most CT scans are performed in seconds, although it can take 10 minutes of longer to position the child correctly for the exam. It is noninvasive and highly accurate, and provides more detailed images of the bony and soft tissue structure of the head and neck than conventional x-rays.

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- Sandra L. Fenwick, President and CEO

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