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Case of the Month: May 2013, Page 2
Answer: B) Cavernous malformation
- This lesion in this case at the junction of the pons and midbrain demonstrates the classic "popcorn ball" appearance on T1WI and T2WI, which reflects varying-age blood products, hemorrhagic fluid, and hemosiderin.
- In this case areas of increased signal are more acute hemorrhage, which likely caused her symptoms
- Note that there is little to no enhancement on the post-contrast image
- GRE demonstrates low signal due to blood products from prior hemorrhage
- Cavernous malformations are benign vascular lesion with closely apposed immature blood vessels, intralesional hemorrhage, and no neural tissue
- Occur throughout CNS
- Propensity for growth via repeated intralesional hemorrhages, Sporadic (0.25-0.7% per year)
MR T1 with gad
Given the above images, what is the diagnosis?
A) Developmental venous anomaly
B) Venous thrombosis
D) Mixed vascular malformation
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