THE ARTERIOGRAPHIC PATTERN ACCOMPANYING CENTROSYLVIAN MASS LESIONS

¹ From the Department of Radiology and the Division of Neurosurgery, College of Medicine, University of Cincinnati and Cincinnati General Hospital, Cincinnati, Ohio

Despite implications from previous literature that angiography is unreliable in the diagnosis of centrosylvian mass lesions, the present authors believe that a specific arteriographic pattern does occur with significant consistency. The pattern includes downward and outward displacement of the middle cerebral artery as seen in the frontal projection and upward migration of the middle cerebral complex, as shown in the lateral projection. A series of 100 cases were reviewed using measurements of the sylvian (B) and "insular" (A) points from the internal skull table and of the displacement of the middle cerebral complex from the clinoparietal line. The survey disclosed that only 7 pen cent fell within the normal limits of these measurements. The mechanisms leading to the arteriographic pattern are postulated. Most centrosylvian mass lesions are hemorrhagic infarcts and their identification angiographically may lead to improved clinical management.

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