Cavernous Angioma

br-7404.gif

      They are characterized by a honeycomb of endothelium-lined vascular spaces, separated by fibrous, collagenous bands with no intervening neural tissue. Most cavernous angiomas are asymptomatic and are noted incidentally on MR scans. They may cause seizures or a focal neurologic deficit, and on occasion they will be of sufficient size to produce symptoms by mass effect. The intralesional hemorrhages are usually small and occult clinically. Multiplicity is common.

      Cavernous angiomas invariably contain hemosiderin from chronic hemorrhage and are distinctly hypointense on T2-weighted MR images. Lesion margins are "fuzzy" due to the magnetic susceptibility effect of the hemosiderin, and a "blooming effect" occurs with gradient-echo sequences. Calcification is often present. Mild enhancement can be obscured by the hemosiderin. Endnote

      Larger cavernous angiomas have a more complex appearance from multiple hemorrhages of varying ages. Hemosiderin lines the perimeter of these lesions and also outlines the internal compartments that contain various components of hemorrhage. Endnote  

{To return to cases, use the "Back " button on the Toolbar}