Cerebral cavernous malformation
70 yrears old female with headache and seizures.
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- a left anterior-frontal subcortical ovoid 2 X 1.5 cm hemorrhagic lesion is seen, it demonstrates heterogenous, predominantly hyperintense T1 and T2 signal intensity (met Hb signal of subacte blood) with T2 hypointense rim (haemosidrin ring). The lesion is associated with no significant vasogenic brain edema or mass effect.
- left high anterior frontal cortical and subcortical small area of T2 / FALIR hyperintensity are seen with no restricted diffusion (small vessel disease).
- normal MRA of the brain
This case demonstrated a typical cerebral cavernous malformation (cavernoma)
A popcorn-like lesion with T2 hypointense ring of hemosiderin is virtually diagnostic of cavernous malformation (cavernoma) of the brain.
Cavernous malformations (cavernoma) could be multiple, so T2* or SWI-GRI sequence must be done particularly in patients with spontaneous hemorrages.
The annual hemorrhage was 0.6% in patients who never had a symptomatic hemorrhage. Patients who had prior hemorrhage have a higher (4.5%) annual hemorrhage rate.
The differential diagnosis of popcorn- likle lesions are: A-V malformation, hemorrhagic and calcified neoplasms.