Cerebral cavernous malformation (large)
Long standing epilepsy
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Within the left occipital pole is a 32 x 36 x 38 mm lesion with a complete surrounding hemosiderin ring, and heterogeneous signal including regions of intrinsic T1 signal. The features are characteristic of a large cavernous malformation. There is no surrounding edema to suggest recent hemorrhage. No abnormal flow voids or vessels are demonstrated to suggest an associated vascular malformation (e.g. developmental venous anomaly).
A small (7mm) region of susceptibility induce signal loss only appreciable on susceptibility weighted imaging involves the posterior inferior aspect of the left thalamus. This is not clearly visible on other sequences but could represent a second much smaller cavernous malformation, or a small capillary telangiectasia.
Typical appearances of a large cavernous malformation.