Case of the Month: May 2013, Page 2

Answer: B)  Cavernous malformation


Imaging findings

  • 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)

For full size-images click on Neurological Deficit 5 and Neurological Deficit 6 .

MR T1 with gad


Given the above images, what is the diagnosis?
A)  Developmental venous anomaly
B)  Venous thrombosis
C)  Hemangioblastoma
D)  Mixed vascular malformation

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