Cavernous Angioma

The patient is a 19 year old sophomore who presented in 1983 with numbness of the left hand, involving initially just the fingers, and numbness and weakness of the right side of the face. He described the numbness in his hand as if it was "intensely asleep". The facial numbness involved the perioral region. Over the next five days, prior to admission (PTA), the numbness spread to involve the whole left side of his body, and extended over a greater area of the right face to involve the cheek and right side of his tongue. One day PTA, he developed a mild occipital headache and unsteadiness standing and walking. He was admitted to an outside hospital. Brain CT: The scan revealed a mass lesion in the region of the fourth ventricle which was thought to represent a brain tumor. He was transferred and admitted to the Massachusetts General Hospital. Ocular Motility on arrival: Primary position upbeat nystagmus Rotary clockwise nystagmus on gaze left Horizontal gaze evoked nystagmus on gaze rig