Pontine Cavernoma with Hemorrhage

Findings:

Multiple MR images demonstrate a parenchymal hematoma in the left pons. There is no significant abnormal enhancement associated with this lesion. A small amount of surrounding edema is present with partial effacement of the fourth ventricle. The hemorrhage within this lesion is of mixed age. There is slight exophytic extend into the prepontine cistern.

Discussion/Differential Diagnosis:

The differential diagnosis for intracranial hemorrhage is broad, but does include vascular malformations such as cavernoma and arteriovenous malformations. No enlarged vessels or tangle of vessels is seen in this region to suggest that this represents an AVM. The absence of significant nodular enhancement indicates that neoplasm is unlikely. The hemorrhage is also more extensive than would be expected for a hemorrhagic infarct. Overall, the features are most compatible with cavernoma, with multiple other discussions and examples of cavernomas on this site below:

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