Multiple intracranial cavernomas and colloid cyst

Case contributed by George Harisis
Diagnosis almost certain


60 year old male, follow up of known intracranial lesions.

Patient Data

Age: 60 years
Gender: Male

There is a round, hyperdense lesion centered at the foramen of Monro, appearance is compatible with a colloid cyst. No associated hydrocephalus.

Multiple intraparenchymal supra and infratentorial hyperattenuating lesions, the largest in the left medial frontal lobe. No surrounding vasogenic edema or mass effect.

There is a 7mm colloid cyst centered at the anterior aspect of the 3rd ventricle with no evidence of hydrocephalus.  Innumerable foci of blooming artefact on susceptibility weighted imaging both infra and supratentorially, the largest in the left frontal lobe measuring 13 x 16 mm appears homogenously T1 hyperintense, in keeping with recent central hemorrhage. 

Larger lesions are likely to represent cavernomas while the smaller foci of blooming signal change are less specific and the possibility of co-exiting amyloid angiopathy is not excluded

Right temporal and right occipital superficial siderosis.  

Case Discussion

This case nicely demonstrates at least two distinct intracranial lesions, both of which were asymptomatic in this patient.

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