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Rare disease
Unilateral facial palsy in an infant: an unusual presentation of familial multiple cerebral cavernous malformation
  1. Zaitun Zakaria1,
  2. Chandrasekaran Kaliaperumal2,
  3. John Caird2,
  4. Mohammad Sattar2
  1. 1Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland
  2. 2Department of Neurosurgery, Children's University Hospital, Dublin, Ireland
  1. Correspondence to Chandrasekaran Kaliaperumal, ckaliaperumal{at}gmail.com

Summary

Cerebral cavernous malformation (CCM) in infants tends to have genetic predisposition. These cavernomas have a progressive course of events and associated neurological symptoms with increase in age. They most commonly present with seizure and syndrome of increased intracranial pressure comprising of headache, vomiting and focal neurological signs. We describe a case of a 7-month-old infant who presented with an acute onset of right facial paralysis with a background of familial CCM. The CT and MRI scan revealed fresh haemorrhage in the right cerebellar and pontine cavernomas with surrounding oedema and no evidence of obstructive hydrocephalus. These two cavernomas re-bled in a week duration causing episodes of incessant crying and irritability. After discussing the pros and cons of treatment, owing to stable clinical status, the patient is currently been managed conservatively.

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