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AJNR - American Journal of Neuroradiology

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Facial Hemangioma and Hemispheric Migration Disorder: Presentation of 5 Patients

I. Pascual-Castroviejo^a, S.-I. Pascual-Pascual^a, J.-C. López-Gutiérrez^b, R. Velazquez-Fragua^a and J. Viaño^c

^a Pediatric Neurology Service, University Hospital La Paz, Madrid, Spain
^b Pediatric Plastic Surgery, University Hospital La Paz, Madrid, Spain
^c Imaging Unit, Rosario Clinic, Madrid, Spain

View larger version (60K): [in this window] [in a new window]   Fig 1. A, Patient 1. Right carotid arteriography. Both cerebral hemispheres are supplied by the right internal carotid artery. Enlarged anterior cerebral artery (arrowhead). B, Same patient. Axial T2-weighted (200/100) image shows an abnormal small left hemisphere with a round gray matter mass (arrow), which is criss-crossed by several large vessels. C, Coronal MRA of the neck shows absence of the left internal carotid artery and hyperplasia of the right internal carotid artery (arrow). Normal size of both vertebral arteries (arrowheads).

View larger version (34K): [in this window] [in a new window]   Fig 2. Patient 3 at 16 years of age. A, Axial T1-weighted MR image shows hypoplasia of the left cerebral hemisphere with enlarged lateral ventricle and polymicrogyria in the same hemisphere. B, MRA study of the same patient. The axial view shows right internal carotid artery hyperplasia with vascularization of both anterior cerebral hemispheres from a large right anterior cerebral artery (large arrowhead) and poor vascularization of the left cerebral hemisphere. Collateral vascularization from the ophthalmic (arrow) and the external carotid arteries to the middle cerebral artery in the left side (small arrowhead).

View larger version (20K): [in this window] [in a new window]   Fig 3. A, Patient 5. Axial T1-weighted MR image shows hypoplasia of the left cerebral hemisphere with enlarged lateral ventricle and polymicrogyria of the anterior part of the hemisphere. B, Coronal view of MRA shows left carotid artery hyperplasia and intracavernous origin of the left anterior cerebral artery from which the right anterior cerebral artery (asterisk) also originates, and persistence of the trigeminal artery (arrow). The vertebrobasilar system is normal. C, Axial view of MRA shows the presence of the trigeminal artery in the left side (arrowhead).