Giant cavernous hemangiomas of the brain

Abstract

Cavernous angiomas or hemangiomas or cavernomas are benign, vascular malformations of the central nervous system and classified as occult vascular brain lesions, usually present in adulthood. With the advent of computed tomography and magnetic resonance imaging, these lesions are increasingly recognized in children. We report two cases of pediatric brain cavernomas where the children presented with recurrent seizures. Imaging findings were suggestive of giant cavernous hemangioma. The lesions were excised completely and the patients recovered well without deficits with good control of seizures.

Keywords: Cavernous hemangioma; epilepsy; giant; magnetic resonance imaging.

Figure 1

(a) CT scan brain plain showing well-defined lesion in left temporoparietal region with evidence of hemorrhage, (b) Follow-up CT scan showing complete excision

Figure 2

(a) and (b) MRI T1W, T2W axial images showing reticulated core of mixed signal representing blood in various states of degradation, note the hypointense halo due to hemosiderin on T2 W image (b), (c) Photograph of completely excised lesion with surrounding gliotic tissue

Figure 3

Photomicrograph of the specimen showing giant cavernous angioma with large ectatic endothelium-lined variable size vascular channels without mural muscular or elastic fibers embedded within a matrix of collagenous tissue. Also note the associated gliosis, calcification, and hemosiderin deposition in the surrounding neural parenchyma