Radiation-Induced Cavernomas of the Brain
Rajan Jaina,
Patricia L. Robertsonb,
Dheeraj Gandhia,
Sachin K. Gujara,
Karin M. Muraszkoc and
Stephen Gebarskia
a Department of Radiology, University of Michigan Medical School, Ann Arbor, MI
b Department of Neurology, University of Michigan Medical School, Ann Arbor, MI
c Department of Neurosurgery, University of Michigan Medical School, Ann Arbor, MI
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FIG 1. Case 1.
A, Axial T2-weighted MR image obtained 12 years after craniospinal radiation therapy at 3 years of age for a posterior fossa medulloblastoma showing no lesion in the left temporal lobe/temporal horn.
B, Axial T1-weighted and, C, fluid-attenuated inversion recovery (FLAIR) MR images obtained 15 years after the radiation therapy, showing a lobulated area of mixed signal intensity with peripheral hypointense rim (white arrow) in left medial temporal lobe/temporal horn, typical "popcorn" MR appearance of a cavernous angioma.
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FIG 2. Case 2.
A, Axial T2- and, B, T1-weighted MR images obtained 3 years after involved field radiation therapy at 3 years of age for a posterior fossa ependymoma showing a large hemorrhagic, lobulated lesion of mixed signal intensity (white arrow) in left cerebellar hemisphere and vermis. Two more small cavernomas (black arrowheads) are seen in the right cerebellum. Postoperative changes (black arrow) are noted in the right cerebellum.
C, Axial T2-weighted MR image shows an area of blooming due to another small cavernoma (black arrow) in the right temporo-occipital region.
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FIG 3. Case 4.
A, Axial T2-weighted MR image obtained 6 years after craniospinal radiation therapy at age 13 years for a suprasellar germinoma showing no lesion in right frontoparietal region.
B, Axial T2-weighted and, C, FLAIR MR images obtained 8 years after the radiation therapy showing interval appearance a round lesion of mixed signal intensity with a fluid-fluid level and peripheral hypointense rim (black arrow) in right frontoparietal region.
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