Cavernous Angiomas of the Brain

Kim, Y G; Lee, S H; Cho, B G

Abstract

With the advent of computed tomography(CT) scan and magnetic resonance image(MRI), the detection of cavernous angiomas of the brain has been increased over the last few years. The authors reviewed 12 surgically proven cases of cavernous angiomas of the brain admitted between January, 1980 and June, 1990. The clinical characteristics, radiological features, surgical findings, and postoperative results were studied. There were 4 males and 8 females. The mean age at the time of diagnosis was 20.3 years, ranging from 4 months to 53 years. The common presenting symptoms were seizure(6 patients), acute hemorrhage(3 patients), and mass lesion(3 patients). All cases were located at the supratentorial region and two of them had giant cysts. Frequent CT findings were high density masses with minimal or no contrast enhancement. The characteristic feature on the T2 weighted MRI was a mixed signal intensity(SI) lesion associated with a surrounding rim of low SI which represented hemosiderin deposits. Ten patients underwent surgery with complete excision and all but one had no further neurological deficits. Two patients underwent partial resection with subsequent regrowth of the masses. Six cases initially presented with seizures showed improvement in seizure frequency. These findings suggest that seizure disorders presenting as a hyperdense mass on CT and/or as a mixed SI core combined with a surrounding low SI rim T2-weighted MRI have a high possibility of cavernous angioma. The cavernous angiomas can be resected without further neurological deficit when they are located surgically accessible areas of the brain.