Board Review 1 – Case 16

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

This case shows a solitary lesion with central T2 hyperintensity and surrounding siderosis (dark on T2). The area shows no real enhancement, although there is a linear branching structure adjacent to the lesion

The diagnosis is: cerebral cavernous malformation

Cerebral cavernous malformations are angiographically occult vascular malformations which consist of clusters of abnormal capillaries without a shunt. Their characteristic appearance is a rim of hemosiderin which may take on the appearance of a popped popcorn kernel. Developmental venous anomalies (DVAs), are often seen with isolated cavernous malformations.

Other times, patients may have multiple lesions which can be associated with familial syndromes.