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Cerebral cavernous venous malformation

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

Headache.

Patient Data

Age: 22
Gender: Female

CT Brain (selected images)

ct

There is a small nodule in the right temporo-occipital transition which is not well delineated and shows to be high hyperdense (blood). No unequivocal contrast enhancement is noted. 

MRI Brain (selected images)

mri

The small nodular lesion in the right lateral occipitotemporal gyrus is again demonstrated with its intrinsic peripheral high T1 signal and its complete rim of signal loss due to hemosiderin staining. It seems to be stable compared to the previous studies. There is no surrounding edema.

Remainder brain is unremarkable.

Intracranial arterial circle of Willis is unremarkable with no aneurysm or other vascular malformation demonstrated (not demonstrated above). 

Conclusion: MRI features are in keeping with a stable cerebral cavernous venous malformation.

Case Discussion

Cavernous venous malformation is a common cerebral vascular malformation characterized, as in this case, by a “popcorn” appearance with a rim of signal loss due to hemosiderin, which demonstrates prominent blooming on susceptibility weighted sequences. T1 and T2 signal is varied internally depending on the age of the blood produces and small fluid-fluid levels may be evident.

 

 

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