Thoracic Spinal Cord Cavernoma

38-year-old male with left trunk parasthesias and weakness of many years duration. There is a subtle, linear region of T2-hypointense signal within the left central aspect of the thoracic spinal cord substance with patchy linear enhancement at that site on the sagittal and axial postcontrast T1-weighted images. Given the apparent hemosiderin deposition within the cord substance and location, a cavernoma was suspected. A spinal angiogram was performed to exclude the possibility of an underlying AVM of arteriovenous fistula. Spinal cord cavernomas are rare, occurring in 5% of cases of intramedullary lesions in adults. The lesions are more common in females with peak presentation in the fourth decade. Typical presenting symptoms include pain, parasthesias, and weakness. Greater than half of spinal cavernomas occur in the thoracic cord.