Figure 137

Ganglioglioma. Horizontal post-contrast T1W image of a left posteriomedial temporal lobe mass. The cystlike lesion with an enhancing mural nodule is a classic appearance for gan-glioglioma.

Sturge-Weber (encephalotrigeminal angiomatosis) is a sporadic disorder characterized by angiomatosis involving the eye, face (facial nevus flammus, or port-wine stain), and/or leptomeninges. Intracranially, there is a disorganized angiomatosis of the leptomeninges involving the capillaries, venous channels, and arteries, with characteristic "matting" and fibrosis. There is also typically diffuse calcification of the underlying cortex, most commonly in the temporo-parieto-occipital region secondary to ischemia. Typical findings on MR include weblike enhancement of the subarachnoid space, corresponding to the matted vasculature of the pial angioma (Figure 13-9). Calcification of the underlying cortex is best visualized on CT or MR T2-weighted images and is usually unilateral. The ipsilateral choroid plexus may also be enlarged (22), and may be correlated with the extent of pial angiomatosis (23).

Arteriovenous malformations (AVM) are abnormal, often friable connections between cerebral arteries and veins without intervening capillaries. Thought to be congenital, AVMs may grow over time, resulting in hypoper-fusion and the development of aneurysms, and can cause seizures, neurologic deficits, headache, hydrocephalus, or hemorrhage (24). CT is most sensitive in the detection of hemorrhage that presents acutely. CT angiography with 3D reconstructions can help delineate feeding artery and draining vein anatomy (25) (Figure 13-10, long white

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