Spinal Cavernous Malformation

spinal cavernoma

These sagittal MR images of the spine (T1W left, T2W right) show a rounded spinal lesion with surrounding low signal on both sequences. The low signal appears to expand the central canal both proximally and distally. The low signal is due to old blood products (eg haemosiderin) which are typically found surrounding cavernomas.

The spinal cord is an uncommon site, accounting for only 3-5% of all cavernomas. The acute bleeding rate is 1-5% per lesion per year. Clinical course may be slow, or sudden onset para- or quadraplegia. The brain should always be scanned using a gradient echo sequence, as there is a high incidence of multiple lesions (10-30%). 20% of patients have familial cavernous malformation syndrome (autosomal dominant), and family member screening should be considered when there are multiple lesions.

Reference: Ross JS, et al. Diagnostic Imaging: Spine. Amirsys 2004

Credit: Dr Laughlin Dawes