Middle cerebellar peduncle cavernoma

Case contributed by Jack Ren
Diagnosis almost certain

Presentation

Unsteadiness.

Patient Data

Age: Adult
Gender: Female

MRI brain

mri

A right middle cerebellar peduncle oval-shape 1.5 x 1 cm is seen eliciting hyperintense  T1 and T2 signal. The lesion has well defined edges with thin hypointense coat in all sequences, more noticeable on Gradient Echo sequences consistent with hemosiderin staining. A small amount of surrounding high T2 signal is present, best seen on FLAIR, suggesting recent bleed. 

Case Discussion

Cavernous hemangiomas (a.k.a. cavernomas) are common and can occur anywhere in the brain and even in the spinal cord. They are often asymptomatic but some present with repeated bleeds and gradual enlargement. Surgical resection is curative. 

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