Cavernous malformationBy mahyarHistory: A 24Y/F with seizure Findings:
:: CT 1 ::Axial non-contrast CT : Well-delineated round hyperdense lesion with punctate Ca++
:: CT 2 ::Axial non-contrast CT: Multiple well-delineated round hyperdense lesions with punctate Ca++
:: MRI 1 ::T2W-coronal Brain MRI without Gd Mixed signal core, complete hypointensehemosiderin rim in the LT paraventricular area
:: MRI 3 ::T2W-coronal Brain MRI without Gd Mixed signal core, complete hypointensehemosiderin rim in the right and left frontal
:: MRI 4 ::T2W-Sagittal Brain MRI without Gd
:: MRI 5 ::MRA
:: MRI 6 ::MRA AFTER 3 MONTH Normal
:: X-Ray 1 ::Right CCA ANGIOGRAPHY Normal
:: X-Ray 2 ::Left CCA ANGIOGRAPHYnormal Discussion: -> Benign vascular hamartoma with masses of closely apposed immature blood vessels ("caverns"), intralesional hemorrhages, no neural tissue -> CMs exhibit range of dynamic behaviors (enlargement, regression, de novo formation) -> 75% occur as solitary, sporadic lesion -> 10-30% multiple, familial Imaging Findings -> Mixed signal core, complete hypointense hemosiderin rim -> Locules of blood with fluid-fluid levels -> Prominent susceptibility effect (hypointense "blooming") -> DSA usually normal ("angiographically occult vascular malformation") -> Best imaging tool: MRI (use T2* sequence; standard Tl-, T2WI may be negative in small Type 4 lesions!) Differential diagnosis: AVM • Hemorrhagic neoplasm • Calcified neoplasm • Old trauma (DAI, contusions) • Amyloid angiopathy (elderly, demented, white matter disease) • Capillary telangiectasias Diagnosis confirmation: Other Category: Neuro Region / Organ: Head-Brain and brain nerves Etiology: congenital References: Diagnostic Imaging: - Anne G. Osborne Get more for Cavernous malformation Peer-reviewed resources Literature  More publications about Cavernous malformation Challenge yourself with the case quiz! |