Presentation
Dizziness and headache. Previous right temporal lobe stroke two years ago.
Patient Data
Selected images of MRI brain demonstrate a nodular well-defined lesion in the left temporal operculum measuring 15 mm in its longest axial axis, showing low T1 signal, high T2/FLAIR signal with a rim of dropped signal on T2, and blooming artefact on SWI. No surrounding edema is noted. No restricted diffusion.
Partially contemplated gliosis on the right temporal lobe as a sequelae of the previous known stroke.
Case Discussion
The imaging features of the left temporal operculum are suggestive of a cerebral cavernous venous malformation.
As an isolated and medium lesion, the differential diagnosis for such lesion is really short, and maybe done between a hemorrhagic cerebral metastasis or a hemorrhagic primary brain tumor (such as GBM), however, in both we would expect mass effect and surrounding edema, which are not features of the present nodule.
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