Presentation
Right-sided numbness including the face of a few months duration and chronic headache.
Patient Data
Posterior pontine lesion and right deep parietal periventricular similar lesion involving the caudate nucleus body, both lesions elicit complex low and high signal intensities in T1 and T2, low signal hemosiderin rim with characteristic popcorn" or "berry" appearance and marked blooming in the T2 GRE.
The dorsal pontine lesion is seen bulging posteriorly indenting the fourth ventricle.
Upper marginal T2/flair hyperintensity is seen surrounding the right cerebral lesion probably related to edema or gliosis
Mild dilatation of the supratentorial ventricular system with no CSF permeation is probably related to partial CSF follow compromise at the fourth ventricular level.
Case Discussion
MRI revealed right cerebral and brainstem lesions of a characteristic “popcorn” or "berry" appearance with a rim of signal loss due to hemosiderin, which demonstrates prominent blooming on susceptibility-weighted sequences (T2*).
These pictures are pathognomonic of cavernomas.
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