Cerebral cavernomas

Case contributed by Dr Fakhry Mahmoud Ebouda

Presentation

Left-sided weakness and decreased sensation.

Patient Data

Age: 50 years
Gender: Female
MRI

Right posterior parietal focal area of the abnormal signal intensity seen. It appears high signal on FLAIR, T2 and low on T1WI with a tinge of subtle/minor petechiae of hemorrhage that appears high signal and shows evident blooming. Another similar focal but smaller lesion is seen in the right occipital region. The first one is surrounded by perilesional edema. No significant mass effect could be elicited.

Case Discussion

Cerebral cavernous venous malformations also named cavernomas or cavernous hemangiomata, which are a vascular abnormality of the central nervous system. They contain blood products at various stages of evolution. The first one is surrounded by perilesional edema owing to the possibility of a recent bleed. They are usually <3 cm in size. The risk of bleed increases with deep brainstem lesions.  Up to 25% of patients present with hemorrhage that can cause headache, followed by neurological symptoms or decreased level of consciousness.

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