Cavernoma, case 4

Clinical history
This 31-year-old male patient was admitted with acute abdominal pain and complains of weakness of both legs, right more than the left side, associated with hypoesthesia. The neurological examination revealed no motor deficit but diminished tendon reflexes and mostly sensory abnormality with hypoesthesia of the lower legs, right more than left.

MRI examination
Image 1: Sagittal T2WI
At the level of TH 10, a small round intramedullary lesion is nicely shown. The center of the lesion is hyperintense and is surrounded by an hypo-intense rim. Moreover, anteriorly within the spinal cord, note the linear hypo-intensity corresponding to signs of old hemorrhage.
Image 2: Sagittal T1WI
Lesion is shown as a spontaneously hyperintense area.

Conclusion
Intramedullary cavernoma.

Clinical evolution
After six months, the patient's neurological status improved. Follow-up MRI not shown here demonstrated reduction in size of the lesion and hence no surgical procedure was performed.

Typical presentation of an intramedullary cavernous hemangioma. Whenever a cavernous hemangioma is suspected, MR examination should include brain MRI. In this case indeed, similar small lesions were seen in the brain which confirmed the diagnosis of multiple cavernous hemangiomas.

Search also:
- Cavernoma

The ESNR CD-Rom Series