Multiple intracerebral cavernous angioma--case report

A 65 Year-old man with an episode of absence attacks and mild mental changes was admitted to the clinic. A skull X-ray film demonstrated a mild spotty calcification in the left frontal region. The lesion was recognized as a heterogeneous high density and irregular round egg-sized tumor on computerized tomography and appeared as an avascular mass with cerebral angiography. The patient also had abnormal low-intensity spots that were widely scattered in the supratentorial, parieto-temporal cortex, cerebellum and the pons on MRI (gradient-field echo method). Abdominal echography demonstrated a single tumor shadow in the liver. Only the frontal lesion removed and histological examination confirmed the diagnosis of a cavernous angioma. The scattered low density lesions observed with the MRI (both T1 and T2 weighted) were also indicative of a cavernous angioma. These lesions were probably caused by hemosiderin at different phases of chemical breakdown. The cases of multiple cavernous angiomas reported by McCormick and Rubinstein had a similar appearance with a spot-shaped hemorrhage or angioma. Many other reports of multiple lesions will probably appear in the future with the use of MR, since a small cavernous angioma can be easily visualized by gradient-field echo method.