Cavernous malformation of the corpus callosum


Diagnosis: cerebral cavernous malformation


  • represents a benign vascular hamartoma
    • contains masses of closely apposed immature blood vessels ("caverns"), no neural tissue
    • intralesional hemorrhages of different ages
  • exhibit a range of dynamic behavior (enlargement, regression, de novo formation)


  • vary from microscopic to giant (> 6 cm)
  • locules of variable size contain blood products at different stages of evolution
    • variable appearance depending on hemorrhage/stage
  • Zabramski classification
    • type 1 = subacute hemorrhage (hyperintense on T1WI; hyper-/hypointense on T2WI)
    • type 2 = mixed signal intensity on T1, T2WI with degrading hemorrhage of various ages (classic "popcorn ball" lesion)
    • type 3 = chronic hemorrhage (hypo- to iso on T1, T2WI)
    • type 4 = punctate microhemorrhages ("black dots"), poorly seen except on T2* sequences
  • angiography is usually normal ("angiographically occult vascular malformation") unless the lesion is extradural

Differential considerations include:

  • arteriovenous malformation
  • hemorrhagic neoplasm
  • calcified neoplasm
  • hypertensive microbleeds
  • cerebral amyloid angiopathy