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Images in Neurology |

Multiple Cavernous Angiomas in the Brain and Spinal Cord

Hiroya Kuwahara, MD; Yoshimasa Noguchi, MD; Yukinobu Saito, MD, PhD; Akira Inaba, MD, PhD
Arch Neurol. 2010;67(11):1405-1406. doi:10.1001/archneurol.2010.270.
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A 68-year-old man developed a generalized convulsion. He had undergone resections of cutaneous cavernous angiomas in the neck, chest, and abdomen 3 years earlier. Brain T2*-weighted magnetic resonance images (MRIs) showed multiple low-intensity nodules extensively in the whole brain (Figure 1). The sizes of the lesions were mostly less than 1 cm. The number of lesions was too high to count, but there were at least 150 in the cerebrum, 50 in the cerebellum, and 10 in the brainstem. Brain magnetic resonance angiography showed no abnormal findings. Electroencephalography revealed diffuse slow basic rhythm without paroxysmal activity after administration of the initial intravenous dose of phenytoin. Cervical T2*-weighted MRIs also showed low-intensity nodules in the spinal cord (Figure 2). Retinal abnormalities were not detected by means of ophthalmologic examination.

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Figure 1.

Axial T2*-weighted magnetic resonance images showing numerous low-intensity nodules extensively in the cerebrum, cerebellum, and brainstem.

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Figure 2.

Sagittal T2*-weighted magnetic resonance image showing low-intensity nodules (arrows) in the lower cervical and upper thoracic regions of the spinal cord.

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