Cerebral cavernous venous malformation

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Seizures.

Patient Data

Age: 10 years
Gender: Male

MRI Brain

mri

An intra-axial cortical and subcortical right posterior parietal focal lesion is present. It shows mixed intensities with a T2 hypointense rim of hemosiderin giving reticulated "popcorn pattern" and shows a peripheral T1 hyperintense component matching with subacute bleeding surrounded by mild perifocal edema with slight effacement of the adjacent cortical sulci. In the susceptibility weighted sequence (SWI) the lesion shows positive blooming confirming its hemorrhagic nature.

Case Discussion

Features are suggestive of right posterior parietal cavernoma with signs of associated subacute bleeding and mild mass effect. It is considered Zabramski type I as it reflects subacute hemorrhage confirmed by the hyperintensity on T1 and T2 as well as blooming on SWI.

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