Rapid growth in a cavernoma

The availability of magnetic resonance imaging has greatly increased the de tection of cavernous malformations of the central nervous system in both sy mptomatic and asymptomatic patients. These lesions may be responsible for p reviously unexplained neurological events or may even have been incorrectly diagnosed. We describe a patient presenting with focal neurological signs in whom an initial diagnosis of malignant glioma had been made. Following e xcision, the pathological diagnosis was cavernoma. This vascular lesion has continued to show rapid growth and aggressive behaviour despite multiple s urgical resections. The indications for operative and non-operative interve ntion will be discussed.