Multiple cavernoma syndrome

Discussion:

This patient is from a known pedigree of autosomal dominant multiple cavernoma syndrome

The differential for this case would include neurocysticercosis and cerebral amyloid angiopathy.  

Against the diagnosis of neurocysticercosis is the variability in the size of the lesions, which by the time they calcify are typically more regular, measuring a few millimeters each. Furthermore there is no calcification in this case, although on the sequences provided that cannot be proven. Review of a CT (not shown) or phase images of the SWI (also not shown) would confirm this. 

Cerebral amyloid angiopathy can have similar appearances however against this diagnosis is that A) the lesions, in this case, are distributed randomly throughout all parts of the brain, not having a predilection for the peripheral subcortical white matter which microhemorrhage of cerebral amyloid angiopathy, and B) there is no evidence of prior larger lobar hemorrhage or superficial siderosis, both of which would be expected in this degree of change. 

 

Case and discussion courtesy of Dr Frank Gaillard.

    Create a new playlist
Loading...