Cavernoma with hemorrhage

Case contributed by A.Prof Frank Gaillard

Presentation

Headache and ataxia.

Patient Data

Age: 40 years
Gender: Female
CT

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.

Case Discussion

The patient went on to have a resection. 

Histology: 

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.

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Case information

rID: 70755
Published: 10th Sep 2019
Last edited: 10th Sep 2019
Inclusion in quiz mode: Included

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