Cavernomas multiple

Most of the DVAs are solitary, although multiple lesions might occur in the blue rubber bleb naevus syndrome, characterized by bluish discolored skin and mucocutaneous lesions. However, there are multiple DVAs in patients that do not have any syndromes or any genetic defect (Figs. 1.8 and 1.9), but the likelihood of a coincident cavernoma seems to be increased in these patients. 

In conclusion, patients with head and neck venous malformations obviously have an increased probability of having a DVA and an increased chance of having multiple DVAs. There are no data on whether the risk of having cavernomas is also increased in this patient subgroup. 

However, multiple DVAs are associated with at least one, sometimes even more than one, cavernoma (Figs. 1.8 and 1.9). 

Multiple cavernomas occur in up to 90% of familial cases and in around 25% of sporadic cases (Clatterbuck et al. 2000 Labauge et al. 2000). Therefore, whenever a single cavernoma is detected on MRI, one has to look for multiple lesions. 

Fig. 2.9a,b. Multiple cavernomas. T2 -weighted gradient echo sequence. There are multiple cavernomas in both cerebral hemispheres and the cerebellum. The T2 sequence is particularly sensitive to hemosiderin... 

Fig. 2.18. Comparison of GRE sequences at 1.5 T (left) and 7 T (right) in a patient with multiple cavernomas throughout the brain 7 T showed the larger extent of all lesions and detected much more additional lesions not seen with 1.5 T...

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