Cerebral cavernous venous malformation (Zabramski type 2)

Case contributed by Dr Subash Thapa

Presentation

Headache with an episode of seizure. No significant family history.

Patient Data

Age: 12 years
Gender: Male

MRI Brain

Modality: MRI

T1, FLAIR hyperintense and T2 heterogeneous lesion involving the left parietal region which demonstrates popcorn ball appearance with enhancement on post contrast T1WI and peripheral blooming on SWI.

There is facilitated diffusion of DWI with a mild restriction on the periphery.

Case Discussion

This case demonstrates a cerebral cavernous venous malformation (Zabramski type-2). 

Cavernomas “angiomas” or “cavernomas” are the intracranial vascular hamartomas. They are collections of blood filled caverns with no normal brain within and lack an arteriovenous shunt 1.

Based on the imaging appearance and stage of evolution cavernous malformation is divided into four types Zabramski classification:

  • type 1: subacute haemorrhage (hyperintense on T1 and T2)
  • type 2: different age hemorrhages (popcorn ball appearance, mixed signal with hyper/hypointensity on both T1 and T2 with fluid-fluid levels)
  • type 3: chronic hemorrhage
  • type 4: punctate micro haemorrhages (blooming black dots on T2* and SWI)
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Case Information

rID: 40310
Case created: 17th Oct 2015
Last edited: 28th Dec 2016
Inclusion in quiz mode: Included

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