Intracranial Cavernomatous Hemangiomas As A Cause of Childhood Temporal Lobe Epilepsy
Intracranial Cavernomatous Hemangiomas As A Cause of Childhood Temporal Lobe Epilepsy
Intracranial Cavernomatous Hemangiomas As A Cause of Childhood Temporal Lobe Epilepsy
Abstract
A 12-year-old boy presented with complaints of seizures since the age of 7 years. Seizure semiology was consistent with
origin from the right temporal lobe. Magnetic resonance imaging of the brain revealed a large right temporal and multiple
small intracranial cavernomatous hemangiomas. The imaging findings and clinical significance of cavernomatous hemangiomas are
briefly discussed.
Keywords
vascular malformation, epilepsy surgery, seizure
Received March 26, 2010. Received revised April 2, 2010. Accepted for publication April 2, 2010.
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Figure 1. T2-weighted axial magnetic resonance image (A) showing a heterogeneous signal intensity lesion in right frontotemporal region with
hypointense rim and focal hypointense areas within. The lesion shows ‘‘blooming’’ on gradient T2-weighted axial image (B). Multiple other focal
lesions (arrows) are identified in other areas on this gradient image. Gradient T2-weighted axial image at a lower level (C) shows multiple
cavernomas in bilateral temporal lobes (white arrows). Note the lesions in cerebellum (black arrows).
causes, viruses, and seeding along biopsy tracts.1 Seizures are Funding
the most common clinical presentation. Medically refractory The authors received no financial support for the research and/or
epilepsy has been reported with temporal lobe cavernomas.3 authorship of this article.
This could be a result of chronic or recurrent microbleeding
within the cavernomatous hemangiomas.4 Cavernomatous
hemangiomas can also cause intracerebral bleeding and References
focal neurological deficits. In conclusion, cavernomatous 1. Tortori-Donati P, Rossi A, Biancheri R. Capillary-venous
hemangiomas are a rare cause of epilepsy in childhood. The malformations. In: Tortori-Donati P, Rossi A, eds. Pediatric
diagnosis is established by the characteristic imaging findings. Neuroradiology. Berlin, Germany: Springer Publications;
2005:319-328.
Contributors 2. Rivera PP, Willinsky RA, Porter PJ. Intracranial cavernomatous
SS worked up the case, and SS and NS reviewed the literature and malformations. Neuroimaging Clin N Am. 2003;13:27-40.
drafted the manuscript. AK provided radiological input. SG was in 3. Armstrong DD. The neuropathology of temporal lobe epilepsy.
charge of the case and approved the final draft. J Neuropathol Exp Neurol. 1993;52:433-443.
Declaration of Conflicting Interests 4. Mottolese C, Hermier M, Stan H, et al. Central nervous system
The authors declared no potential conflicts of interest with respect to cavernomas in the pediatric age group. Neurosurg Rev. 2001;
the authorship and/or publication of this article. 24:55-71.
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