An epileptic guy in his 30s visits the office for follow-up care. He has a history of recurring seizures, which initially manifest as repetitive, jerky movements of his left leg before eventually spreading to affect the entire left side of his body. The patient regularly passes out, and a widespread tonic-clonic seizure has been seen in the patient. The right motor region has a localized lesion, according to neuroimaging. Although he has received treatment with a number of antiepileptic medications, his seizures have remained poorly under control. When the lesion is surgically removed, the brain tissue that was removed reveals a 1.5-cm mass made up of engorged purple clusters. Numerous dilated capillaries with an endothelial lining are visible under a microscope, each one separated by a thin layer of fibrous connective tissue. Which of the following is the most likely diagnosis?

Question

Quizplus · Accepted Answer

Eductional Objective: Cavernous hemangiomas are vascular malformations composed of abnormally dilated capillaries separated by thin connective tissue septa.  The lack of structural support gives them a tendency to bleed, and those that occur in the brain can present with neurologic deficits and seizures.

An Epileptic Guy in His 30s Visits the Office for Follow-Up