Neuroradiology Department, Centro Hospitalar de Lisboa Central, Lisboa, Portugal
- European Congress of Radiology (ECR), 4-8 March 2015, Vienna, Austria
- Published online. DOI: 10.1594/ecr2015/C-0318
Learning objectives: To review the typical imaging characteristics of cavernomas on computer tomography and magnetic resonance, and the key features that allow an accurate diagnosis. To present some atypical cases: unusual characteristics, atypical locations and uncommon complications.
Cavernous malformations are vascular lesions composed of thin walled, dilated capillary spaces with no intervening brain tissue. With an estimated prevalence of 0,5%, they can present anywhere in the CNS. The typical imaging finding is a popcorn appearance, with mixed signal on T1 and T2WI, with a rim of hypointense signal on T2WI and blooming on T2W gradient echo sequences - but there are numerous presentations (from completely calcified to cystic), a radiologist should be aware of.
Findings and procedure details:
We show a collection of illustrative cases of cavernous malformations from our archive. Classical cases will be shown, followed by atypical findings: Giant cavernomas (solid and cystic), uncommon locations such as multiple medullary lesions or tectal, uncommon presentations (hydrocephalus, subarachnoid hemorrhage) and cavernomatosis.
Cavernomas are a common lesion with vastly described imaging characteristics – but in atypical cases diagnosis is not as straightforward. A radiologist must be aware of these variations as to avoid unnecessary or inadequate workup or treatment.