Pneumocephalus mimicking cerebral cavernous malformations in MR susceptibility-weighted imaging.

We read with interest the article by de Souza et al 1 about the use of susceptibilityweighted imaging (SWI) for the evaluation of patients with cerebral cavernous malformations (CCMs). In this regard, we would like to report the following case: In November 2008, a 38-year-old woman presented with a history of left tinnitus and hypoacusis. The usual MR imaging sequences showed a left acoustic neurinoma; she also was found to have a single CCM in the left frontal region as an incidental finding. She underwent surgery, and a small CSF fistula presented through the surgical wound as complication. A new MR imaging was performed, adding SWI, showing several lesions that suggested the presence of multiple CCMs (in addition to the frontal cavernous malformation previously diagnosed) that were not seen on the usual sequences (Fig 1).