Cavernoma with hemorrhage
Headache and ataxia.
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Intraparenchymal hemorrhage at the right posterior fossa measures. Mild surrounding vasogenic edema. The fourth ventricle is slightly compressed and shifted towards the left. Crowding of the basal cisterns and minimal tonsillar descent of approximately 3 mm is also stable. Grey-white matter differentiation elsewhere is preserved. No new intracranial hemorrhage. Ventricular size is unchanged; temporal horns are slightly prominent bilaterally. Imaged paranasal sinuses and mastoid air cells are clear. No calvarial fractures.
The patient went on to have a resection.
MICROSCOPIC DESCRIPTION: Sections show an extensive area of organizing hemorrhage with hemosiderin laden macrophages surrounded by a dilated vessel wall. The Masson Trichrome stain highlights the thick vessel wall with an attenuated elastin layer on Orcein H+E staining. There is no evidence of tumor.
FINAL DIAGNOSIS: features are those of a venous cavernoma with hemorrhage.