Diffuse capillary telangiectasia of the brain manifested as a slowly progressive course

Abstract

Brain capillary telangiectasia (BCT) are usually small, solitary, benign in clinical manifestation, or found incidentally at autopsy. However, diffuse BCT are rarely reported. A 39-year-old woman had the first generalized seizure 10 years previously. Thereafter, she had sustained progressive spastic paraparesis and blurred vision. Computed tomography (CT) showed diffuse brain atrophy with numerous calcified spots. Contrast T1-weighted magnetic resonance images showed diffuse faintly enhancing lesions with stippled appearance in the whole brain. Cerebral angiography revealed multiple small nets of dilated capillaries and Xenon CT showed diffuse low cerebral blood flow in the resting and good cerebral reserve capacity in the acetazolamide challenge test. Therefore, diffuse BCT was diagnosed clinically. Although BCT are not rare, diffuse BCT with slowly progressive neurological symptoms had never been reported before. It causes global cerebral ischemia that lead to brain atrophy and a degenerative course.