Cavernous Angioma: A Rare Cause of Multiple Cranial Nerve Palsies

Acute onset of neurological deficit is highly suggestive of stroke; in such cases, computed tomography (CT) brain is the initial choice of investigation. While CT brain can differentiate between hemorrhagic and ischemic infarct, more often than not, it is unable to detect the underlying etiology of intracerebral hemorrhage. In these situations, magnetic resonance imaging (MRI) brain is crucial in determining the exact etiology and helps us tailor the specific management best suited for our patient. The case under discussion is of a 48-year-old male who presented with multiple cranial nerve palsies and ipsilateral cerebellar involvement in whom CT brain revealed a hemorrhage involving left hemipons and left middle cerebellar peduncle while an MRI brain revealed an unexpected cavernous angioma which changed the management and prognosis of the patient, proving its superiority over CT brain.