Presentation
Seizure
Patient Data
A peripherally hemosiderin stained lesion with central high T1 and T2 signal and a small fluid level is demonstrated. There is no surrounding edema or superficial hemosiderin staining.
A 2nd region of hemosiderin staining inferior to the head of caudate on the left is also noted without surrounding edema.
Four punctate regions of susceptibility induced signal loss scattered throughout both hemispheres and brainstem are additionally noted.
It is worth noting that the heterogeneous signal on the phase images of SWI likely represents aliasing rather than calcification (see SWI article).
The remainder of the brain is unremarkable in appearance. Intracranial circulation is within normal limits
Conclusion:
Features are those of multiple cavernous malformations.
Case Discussion
Typical appearances of multiple cavernous malformations, which are often autosomal dominant in inheritance (multiple cavernoma syndrome).