De Novo Cavernoma in the Sensory Cortex Causing Cervicobrachialgia

Jain Dhruv,Rosahl Steffen K,Rosahl Sophie,Broduhn Michael

doi:10.23937/2643-4474/1710050

Abstract

A 32-year-old female presented with neck pain radiating to the ulnar forearm along with occasional tingling sensations. Three years earlier, she had suffered from left-sided cerebellar infarction caused by dissection of the left vertebral artery. The dissection was provoked by manual therapy administered by a certified physio-therapist. Antiplatelet treatment with Aspirin 100 mg/day was established. One year later, she experienced tingling in the left side of her face. At the time, intracerebral micro-hemorrhage in the right sensory cortex was seen on cranial computed tomography (CCT) and Aspirin was discontinued.

Highlights

IntroductionCerebral cavernous angiomas (synonym: cerebral cavernous malformations; cavernomas) are the third most common cerebral vascular malformation after developmental venous anomaly and capillary telangiectasia [1]
Cerebral cavernous angiomas are the third most common cerebral vascular malformation after developmental venous anomaly and capillary telangiectasia [1]
Superficial cavernomas are associated with a lower risk of hemorrhage than those located in the depth

Summary

Introduction

Cerebral cavernous angiomas (synonym: cerebral cavernous malformations; cavernomas) are the third most common cerebral vascular malformation after developmental venous anomaly and capillary telangiectasia [1]. We report the case of a 32-year-old female who suffered from symptoms classified as cervicobrachialgia that were caused by a rapidly growing de novo cavernoma located in the post central gyrus. An MRI showed a hyperdense lesion in the left postcentral gyrus which was classified as a small cavernous angioma by a radiologist. The tendon of the trapezius muscle was palpably and even visibly tense on the right side Another follow-up MRI was performed on April 20, which showed an increase in size of the lesion to about three times the previous size. The left-handed patient showed a prominent and tense superior tendon of the trapezius muscle on the right side. On January 22, 2020, a small, contrast-enhancing hemorrhagic lesion could be seen in the left postcentral gyrus, more precisely in the somatosensoric area representing the right arm (Figure 1B and Figure 2). Contrast-enhanced scans did not reveal any remnant of the cavernoma

Discussion

Conclusion