Intracranial haemangioma: clinical features and radiological appearances.

Since the advent of magnetic resonance imaging (MRI), intracranial cavernous haemangioma has become the most commonly identified occult vascular malformation. The following case report demonstrates the characteristic radiological appearances and highlights the central role of MRI in the diagnosis of this lesion. CASE REPORT A thirteen-year-old boy presented with a six-week history of a progressive left hemiparesis, with no associated symptoms. Clinical examination revealed an upper motor neurone weakness of the left arm and leg. Examination was otherwise unremarkable. Computed Tomography (CT) (Figure 1) and MRI (Figure 2) of brain were performed. The CT images demonstrate an irregular, mainly hyperdense lesion in the periventricular white matter adjacent to and causing compression of the body of the right lateral ventricle. Foci ofhigh attenuation, consistent with calcification, are present within the lesion, and a surrounding low density zone of oedema is noted. The lesion is seen on MRI to extend superiorly into the centrum semiovale and inferiorly into the upper basal ganglia on the right. It demonstrates a 'popcorn' appearance, with a reticulated core of mixed signal intensities. Appearances are typical of a cavernous haemangioma containing haemorrhage in various stages of evolution.' A peripheral rim of low signal on the T2 weighted