Neuro / Head & Neck for Monday, April 7th, 2025
Contributed by
Seoul National University Children's Hospital
Jae Won Choi, Young Hun Choi, Jung-Eun Cheon, Yeon Jin Cho, SeungHyun Lee, and Jae-Yeon Hwang.
History
11-year-old boy with seizure.
Images (Click any image to enlarge)
Axial T2WI
Coronal T2WI
Sagittal T2WI
DWI, b=1000
SWI
T1WI
T1WI post-contrast
DSC CBV map
C-11 Methionine PET
Question
What is the most likely diagnosis?
Your answer
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Correct answer
Cavernous malformation
Discussion
Although cavernous malformations are usually intra-axial, there are case reports of extra-axial cavernous malformations
- Cavernous sinus/suprasellar/parasellar >> cerebellopontine angle > convexity ~ falx/tentorium
Imaging pitfalls
- Can show dural tail sign
- Absent hypointense rim (surrounding hemosiderin), contrary to the typical intra-axial cavernous malformation.
References
- Asian J Neurosurg. 2022 Jul 15;17(1):120-126. J Korean Med Sci. 2006 Oct 31;21(5):950–953. Cureus. 2022 Jul 19;14(7):e27027.