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Synchronous Primary Brain Tumors
Joseph Junewick, MD FACR
over 8 years ago
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Giant Cavernoma

Case Detail

Anatomy: Brain
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 8 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

8 year old female with headache.


Case Images


Diagnosis

Cavernoma

Findings

CT – Lobulated hyperdense midline mass with scattered calcifications.
MRI – Sagittal and axial T1, axial T2-FLAIR and axial post-gadolinium T1 images demonstrate a heterogeneous non-enhancing mass with round areas of T1 hyperintensity.

Discussion

Cavernoma is a benign vascular hamartoma characterized by slow flow and vessels without elastin or smooth muscle. Most cavernomas range in size from a few mm to 2-3 cm; larger cavernoma are referred to as giant.

Patient can present with seizures (40-50%), focal neurological defect (20%) or less often headache. Cavernomas can occur at any age but are most common in the 3rd and 4th decades of life. Occasionally, there is a family history of cavernomas.

Cavernomas account for <1% of intracranial masses and about 10% of CNS vascular lesions. The annual bleeding risk is less than 2%. Almost all cavernomas are associated with microhemorrhage although bleeding leading to clinical symptoms is rare. Risk of bleeding is increased for posterior fossa lesions, in females and in those lesions with previous hemorrhage.

On CT, lesions often demonstrate calcification with adjacent encephalomalacia. Hemosiderin and gliosis are often seen surrounding the lesion on MRI.



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