An Aggressive Cerebral Cavernous Malformation Presenting With Hemorrhage: A Case Report

Cerebral cavernous malformations (CCMs) are rare vascular malformations that are typically not visualized on cerebral angiography and are often discovered incidentally on brain MRI. However, it may also present symptomatically with seizures or intracerebral hemorrhage. We report the case of a 23-year-old woman in whom a hemorrhagic CCM located in the right temporal lobe was identified following a 10-day history of headache accompanied by nausea and vomiting. Initial management involved conservative observation. However, within approximately one month, the lesion demonstrated two episodes of asymptomatic rebleeding and an increase in size from 33.8 mm to 46.8 mm in maximum diameter, indicating highly aggressive behavior. Given the potential risk of neurological deterioration or even fatal outcomes from further hemorrhages, surgical resection was performed. The patient was discharged without any neurological deficits and is scheduled for follow-up with outpatient MRI surveillance.