Pediatric Cavernous Malformation

Etiology: Low flow vascular anomaly consisting of cluster of hyalinized dilated thin-walled capillaries with surrounding hemosiderin
Imaging:
— Location: Supratentorial 80%, infratentorial 15%, spinal cord 5%
DDX:
Complications: Hemorrhagic stroke which appears as non territorial hematoma with multicentric blooming foci on GRE
Treatment:
Clinical: Sporadic form (66%) associated with solitary lesion, familial form (33%) associated with multiple lesions

Radiology Cases of Cavernous Malformation

CT and MRI of cavernous malformation — Axial (above left) and coronal (above right) CT without contrast of the brain shows a large round high density lesion in the left middle cranial fossa. Axial T1 MRI without contrast of the brain (below left) shows the lesion to have mixed signal intensity while the axial gradient echo MRI (below right) shows a low signal intensity ring around the lesion representing hemosiderin deposition.

CT and MR of cavernous malformation — Coronal (above left) and axial (below right) CT without contrast of the brain shows a slightly hyperdense, round, poorly circumscribed lesion in the right frontal lobe. Coronal T1 MRI without contrast of the brain (above right) shows the lesion to have a popcorn appearance with small round lesions of various signal intensities. Axial gradient echo MRI (below right) shows the lesion to be surrounded by a very low signal intensity ring.