Presentation
Headache and right ptosis.
Patient Data
Right midbrain well defined lobulated space occupying lesion. It shows heterogeneous density with large hyperdense areas and small hypodense areas with faint marginal calcifications. No surrounding vasogenic oedema. It exerts mass effect on the upper portion of the Sylvian aquedcut with mild supratentorial hydrocephalic changes.
Radiological findings are suggestive of cavernous malformation (Cavernoma)
Right midbrain well defined lesion of mixed signal intensities. It elicits high signal on T1, mixed low and high signal on T2 giving the popcorn appearance with blooming on SWI, indicating haemorrhagic contents. It shows a well-defined hypointense margin. It shows mild faint post contrast enhancement. No surrounding oedema. It exerts mass effect on the aqueduct with mild supratentorial mild hydrocephalus.
Findings are impressive of right midbrain cavernoma.
Case Discussion
The case shows the typical CT and MRI features of midbrain cavernous malformation (cavernoma) both on CT and MRI. On CT it appears heterogeneous predominantly hyperattenuating with small hypoattenuating areas within and faint calcifications. On MRI, it shows high signal on T1 WI, mixed low and high signal on T2 giving the popcorn appearance, with marked blooming on SWI.
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