Cerebral cavernoma - recent hemorrhage and associated developmental venous anomaly
Presentation
Frontal headache.
Patient Data
Hypoattenuation in the right frontal deep white matter without grey-white matter loss. Adjacent prominent vein. No intracranial mass or acute hemorrhage identified.
Focal susceptibility artefact mapping to blood product on phase imaging localizes to a mixed T2 signal lesion with a low T2 intensity rim compatible with a cavernoma in the right inferior frontal gyrus. Adjacent vasogenic edema in the adjacent deep white matter. Prominent adjacent vein draining cortically (best seen on SWI) is likely an associated developmental venous anomaly with a subtle Medusa pattern.
Case Discussion
Typical MRI findings of a cavernoma (cavernous venous malformation), which in this case appears to be symptomatic with adjacent edema indicating a likely recent bleed. The edema can be seen on the CT as a region of hypoattenuation, but as a standalone finding this is non-specific. An associated developmental venous anomaly (DVA) is seen on both CT and MRI, which could give you a clue on the CT as to including a cavernoma as a differential.
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