Cavernous malformation — SCE Neurology MCQ

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HardNeuroimagingCavernous malformationSCE Neurology

MRI for focal seizures shows a well-circumscribed frontal lesion with a mixed-signal “popcorn” core and a complete haemosiderin rim on susceptibility imaging. There is no high-flow vascular signal on CTA. What is the diagnosis?

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Correct answer: C — Cerebral cavernous malformation

The best answer is “Cerebral cavernous malformation”. A reticulated mixed-age blood-product core with a hemosiderin rim and angiographically occult behaviour is characteristic of a cavernous malformation, which can present with seizures or symptomatic haemorrhage. “High-flow arteriovenous malformation” is less appropriate because an AVM has identifiable arterial feeders and venous drainage rather than an occult hemosiderin-lined cluster “Pyogenic brain abscess” is less appropriate because an abscess has diffusion restriction and inflammatory rim features “Glioblastoma” is less appropriate because glioblastoma is infiltrative and typically has irregular enhancement, oedema and necrosis “Calcified meningioma” is less appropriate because a meningioma is extra-axial with dural attachment

Reference: Alliance to Cure Cavernous Malformation consensus guidelines. https://pmc.ncbi.nlm.nih.gov/articles/PMC12680281/