Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
October 2013
Next Case of the Month coming November 5 . . .
Cavernous Malformation with DVA
- Cavernous malformations, aka cavernomas, are compact, vascular malformations composed of endothelial-lined sinusoidal spaces containing slow-flowing blood.
- Often intra-axial, rarely extra-axial. Uncommonly in the spine.
- Clinical Presentation: Oftentimes detected incidentally. When ruptured, presents with headache and, occasionally, focal neurological deficit.
- Key Diagnostic Features: "Popcorn-like" lesion demonstrating a hyperintense center surrounded by a hemosiderin/ferritin rim is the classic MR appearance. A fluid-fluid level is seen in the setting of acute hemorrhage. An associated developmental venous anomaly is often seen adjacent to the cavernous malformation and, in fact, sometimes, like in the current case, helps establish the diagnosis.
- DDx: Tumor, aneurysm, arteriovenous malformation, infection
- Rx: Observation, surgical excision
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