Incidental Cavernous Angioma
Introduction: Besides developmental venous anomaly (DVA), arteriovenous malformation (AVM) and capillary telangiectasia, cavernomas are one of the
vascular malformations of the central nervous system. In this case report, we present a case diagnosed with cavernous angioma in the left posterior frontal
region, who presented to our emergency department with the complaint of numbness in her left hand.
Case: A 38-year-old male patient was admitted to the emergency department with complaints of numbness in his left hand in the last few days. Brain CT
examination showed a left sided hyperdensity at the level of vertex, which was suspected of hemorrhage. Afterwards, unenhanced and contrast-enhanced
MRI scans of the brain revealed an image, which was considered primarily as hemorrhagic cavernous angioma, showed minimally heterogeneous intravenous contrast enhancement, hyperintense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and measured approximately 11 mm in size in the left posterior frontal region at high ventricular level. The patient was consulted to neurology and neurosurgery departments,
and was hospitalized in the neurosurgery service.
Discussion: Cavernomas are the third most common vascular malformations after developmental venous anomaly and capillary telangiectasias, accounting for 5-13% of all cerebral vascular malformations. Cavernous angiomas can be seen in any area of the central nervous system (CNS), mostly in cerebral
hemispheres (80%). They are most commonly located in the subcortical region and frontal-temporal lobes in the cerebral parenchyma. The most common
clinical symptoms include epileptic seizures, intracerebral hemorrhage, focal neurological symptoms and headache. Magnetic resonance imaging is the
most sensitive radiological diagnostic method for cavernous angiomas. Asymptomatic cases of cavernous angiomas are followed by periodic MRI studies,
surgical resection of the lesions is recommended because recurrent hemorrhages may cause permanent neurological deficits in symptomatic patients.
Conclusion: In conclusion, patients with cavernoma present with atypical complaints to the emergency department and can be diagnosed incidentally.
Cavernomas are lesions of vascular origin, which tends to be located more frequently in the frontotemporal lobes and subcortical areas, is often accompanied by developmental venous anomalies, and has a radiological appearance that varies according to the extent of hemorrhage.
Keywords: Numbness in the left arm, intracranial mass
Eurasian J Critical Care 2020; 1 (2):167-170 Original Article