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Reminder of important clinical lesson
Cerebral cavernous malformation: a diagnostic challenge in a young patient with intracerebral haemorrhage
  1. Kristijonas Milinis1,
  2. Mohammed Mohammed2,
  3. James Edward Dyer3,
  4. Paul Anthony Sutton4
  1. 1Department of School of Medicine, Univeristy of Liverpool, Liverpool, UK
  2. 2Department of Paediatric Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
  3. 3Department of Urology, Countess of Chester Hospital, Chester, UK
  4. 4Institute of Translational Medicine, Univeristy of Liverpool, Liverpool, UK
  1. Correspondence to James Edward Dyer, james.dyer{at}

An 18-year-old Caucasian man presented with a sudden onset right hemiparesis. On examination, he had objective evidence of an upper motor neuron lesion affecting the right side of his body. CT scan showed a left thalamic haemorrhage. MRI, gradient echo and cerebral angiogram showed no structural lesion and the cause of the bleeding was ultimately attributed to the use of cocaine. During the subsequent 2 years the patient had two further similar episodes, with an MRI eventually demonstrating a cerebral cavernous malformation. This was excised using frameless stereotactic surgery, following which the patient made an uneventful recovery.

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  • Competing interests None.

  • Patient consent Obtained.

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