Clinics in diagnostic imaging (56). Cavernous vascular malformation with intracerebral haematoma

A 28-year-old woman presented following a seizure. Physical and neurological examinations showed no significant abnormality except a drowsy mental state. Routine laboratory studies were normal. Emergency MR imaging showed a rounded, high signal intensity lesion with a focal eccentric heterogeneous signal focus in the right frontal lobe. The heterogeneous focus revealed an irregular low signal rim on T1- and T2-weighted images. Mild surrounding parenchymal oedema was noted. The eccentric focus showed some central enhancement. The diagnosis of cavernous vascular malformation with intracerebral haematoma was confirmed at surgery. The combination of typical MR imaging findings, with clinical and family histories consistent with cavernous angiomata provides sufficient conclusive evidence.