How can a suspected cerebrovascular malformation be diagnosed?

There are four types of cerebrovascular malformations that can be seen clinically: arteriovenous malformations, cavernous hemangiomas, capillary dilation and venous anomalies, of which venous anomalies are the most common, but they are only a developmental variation and most do not cause significant symptoms. It is the arteriovenous malformations and cavernous hemangiomas that cause the most clinical symptoms. Both arteriovenous malformations and cavernous hemangiomas can cause headaches, seizures, and cerebral hemorrhage. There are several ways to diagnose vascular malformations. In addition to a detailed physical examination by a physician, a number of ancillary tests are needed to confirm the diagnosis. Generally speaking, cranial CT (or coupled with vascular imaging CTA) is mainly used to determine whether there is bleeding, and can also see the relatively large vascular malformation lesion itself, but it is very limited; cranial MRI can not only determine whether there is bleeding, but can also see the majority of vascular malformation lesions themselves, and can see the size and location of the above four lesions, and whether there are larger draining vessels, etc. For cavernous hemangiomas, capillary dilation and venous developmental anomalies are the ultimate adjuncts, but MRI may not be able to see smaller arteriovenous malformations, which also need to be clarified by arterial cannulation cerebral angiography, which is generally required before arteriovenous malformations can be treated, allowing for a clearer, more visual and dynamic understanding of the morphology and hemodynamics of the malformation, and the ability to It is crucial to see whether there is an accompanying aneurysm, whether there is a thick arteriovenous fistula and other risk factors that can easily lead to malformation bleeding, whether for endovascular interventional embolization, craniotomy, stereotactic radiosurgery (Gamma knife, X-knife, radio-wave knife, etc.).