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Brain, Cavernous Angiomas: Multimedia
Updated: May 20, 2009
Multimedia
 | Media file 1: Large, right frontal and left occipital cavernous angiomas (same patient as in Images 2-4 in Multimedia). Axial nonenhanced CT image demonstrates a large heterogeneous-appearing lesion in the right frontal region. The lesion is primarily hyperattenuating in its central region, with a more diffuse, peripheral area of increased density resulting from calcification and small areas of hemorrhage. |
 | Media file 2: Large right frontal and left occipital cavernous angiomas (same patient as in Images 1-4 in Multimedia). Nonenhanced axial CT image demonstrates findings of a large primarily hyperattenuating mass in the left occipital region. Note the relative lack of mass effect on the surrounding parenchyma on both CT images (see also Image 1 in Multimedia) and subsequent MRIs (see also Images 3 and 4 in Multimedia). |
 | Media file 3: Large, right frontal and left occipital cavernous angiomas (same patient as in Images 1-4 in Multimedia). T1-weighted axial MRI obtained at a slightly different angle from the CT scan (see Image 2 in Multimedia). The image demonstrates both cavernomas on the same image. These 2 heterogeneous masses have a reticulated core of high and low signal intensities surrounded by a hypointense rim of hemosiderin. |
 | Media file 4: Gradient-echo axial MRI demonstrates increased conspicuity in large right frontal and left occipital cavernous angiomas (same patient as in Images 1-3 in Multimedia). The hemosiderin rim demonstrates a blooming artifact as a result of its increased magnetic susceptibility effects. |
 | Media file 5: This image and those that follow (see Images 5-7 in Multimedia) demonstrate increased sensitivity of gradient-echo sequences compared with T1- and T2-weighted sequences in the detection of smaller lesions. This T1-weighted MRI fails to demonstrate the multiple, tiny cavernomas demonstrated on the gradient-echo image (see Image 7 in Multimedia). |
 | Media file 6: Same patient as in Images 5-7 in Multimedia. A corresponding T2-weighted axial MRI does not demonstrate well the multiple tiny cavernomas seen with a gradient-echo sequence (see Image 7 in Multimedia). |
 | Media file 7: Gradient-echo MRI demonstrates multiple, bilateral punctate and rounded areas of hypointensity within the periventricular and subcortical white matter (same patient as in Images 5-6 in Multimedia). The largest lesion in the periventricular frontal white matter just anterior to the frontal horn of the left lateral ventricle near the genu of the corpus callosum. Multiple smaller lesions are seen both anteriorly and posteriorly. |
 | Media file 8: T1-weighted MRI demonstrates a small hyperintense lesion in the left temporal cortex with a hypointense rim. This smaller lesion is demonstrated better and is more apparent on a T2-weighted image (see Image 9 in Multimedia) and on a gradient-echo image (see Image 10 in Multimedia). |
 | Media file 9: T2-weighted MRI demonstrates the hypointense blooming artifact within the lesion in the left temporal lobe, although the blooming is not nearly as marked as seen on a gradient-echo image (see Image 10 in Multimedia). |
 | Media file 10: The lesion becomes obvious on this gradient-echo image (see also Image 9 in Multimedia). Even this relatively small temporal-lobe lesion is detected easily with this pulse sequence. Because cavernous angiomas are often multiple, a gradient-echo sequence should be performed in addition to standard T1- and T2-weighted sequences to carefully identify all concomitant lesions, as clinically indicated. |
 | Media file 11: T1-weighted MRI demonstrates a pontine cavernous angioma. Note the slightly hypointense lesion located centrally and to the right near the middle cerebellar peduncle. Given its location, a significant hemorrhage can have a clinically devastating result. This lesion demonstrates that location, more than size, is a critical factor in predicting outcome or sequelae of future hemorrhage. |
 | Media file 12: T2-weighted MRI of a pontine cavernoma (same patient as in Image 11 in Multimedia). |
 | Media file 13: Minor amounts of hemosiderin can make smaller lesions evident on gradient-echo MRIs, as seen in this pontine cavernoma. |
 | Media file 14: T1-weighted MRI of the classic popcornlike appearance of a large left-sided cavernous angioma, which primarily affects the temporal lobe. |
 | Media file 15: T2-weighted MRI of a large cavernoma (same patient as in Image 14 in Multimedia). Note the minimal mass effect of this large lesion. |
 | Media file 16: Gradient-echo MRI demonstrates the large amount of blood-breakdown products within this large lesion. Repeated hemorrhage is believed to contribute to the slow growth of some cavernomas over time. |
 | Media file 17: Typical nonspecific appearance of a left frontal-lobe cavernous angioma on a nonenhanced CT scan in this young adult who presented with new-onset seizures. Note the lack of mass effect or surrounding vasogenic edema. |
 | Media file 18: T2-weighted MRI of a left frontal cavernoma (same patient as in Image 17 in Multimedia). |
 | Media file 19: On this T1-weighted MRI, the lesion begins to take on the more characteristic mixed-signal-intensity appearance of a cavernoma (same patient as in Image 18 in Multimedia). Hyperintense bilateral arclike artifact from the patient's metallic dental braces is seen centrally over the basal ganglia and thalamic regions. |
More on Brain, Cavernous Angiomas |
| Overview: Brain, Cavernous Angiomas |
| Imaging: Brain, Cavernous Angiomas |
| Follow-up: Brain, Cavernous Angiomas |
 Multimedia: Brain, Cavernous Angiomas |
| References |
| Further Reading |
| « Previous Page |
References
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Further Reading
Clinical guidelines
Stereotactic radiosurgery for patients with intracranial arteriovenous malformations (AVM).
IRSA - Professional Association. 2003 Sep. 10 pages. NGC:003285
Clinical trials
Influence of MMP on Brain AVM Hemorrhage
Genetic Basis of Hemangiomas
Related eMedicine topics
Brain, Capillary Telangiectasia
Intracranial Arteriovenous Malformation
Temporal Lobe Epilepsy
Brain, Venous Vascular Malformations
Keywords
cavernous angiomas, cavernous malformation, cavernous hemangioma, cavernomas, occult cerebrovascular malformation, intracranial vascular malformations
