Multiple supra- and infratentorial cavernous hemangiomas in a five year-old girl.

Abstract

Cavernous hemangiomas (CHs) are vascular structures comprising abnormally dilated blood vessel clusters. This anomaly is estimated to occur in approximately one out of every 500-600 people.  Individuals often show the first sign of cavernous hemangiomas in their second or third decade. Therefore, the presentation of this disorder is not common in children. This study presents a five year-old-girl who developed abruptly nearly fixed right-sided eye deviation and incoordination after a short course of viral infection. In physical examination, she had left peripheral facial, right eye oculomotor, and left abducens nerve palsy. Her brain's computed tomography (CT) scan revealed hemorrhages in the posterior aspect of the pons and some areas of the hemispheres in different stages. Following brain magnetic resonance imaging (MRI), multiple popcorn ball low-signal T2* lesions with both supra- and infratentorial locations with marked peripheral hypo intensities were seen. These findings were in favor of multiple cavernous hemangiomas of the brain. The novelty of this case was due to observing cavernous angiomas in both supra- and infratentorial spaces in pediatric age.