c.angioma or glioma? reading a MRI

[B__0__0]

  Thanks for providing this great Forum!
  Hopefully someone may be able to help answer a few questions for me.
  How is it possible for a Nuerologist to differenciate between a glioma and a cavernous angioma in a "generalized" MRI scan? In my case, two Doctors read the same scan - a full head scan following a first-time seizure - and both came up with different conclusion.
  What are the characteristics of both types of conditions on a scan, and what is the likelyhood of two different opinions being made?
  Thanks for your time!  
Dear B:
Sorry to hear about your seizures.  Most of the time one should be able to tell you whether the MRI shows a tumor or cavernous angioma.  A cavernous angioma will have a popcorn like appearance (due to bleeding at different times)if bleeding had occurred.  Which, in your case would be likely since you had cortex irriatation causing a seizure.  There should be enhancing areas from the bleeding, hemisiderin.  Most gliomas will not bleed unless they are aggressive.  Most of the time, gliomas or tumors cause seizures due to mass effects on the cortex.  Now, a recent bleed by a tumor might give the appearance that one might call a cavernous angioma.  Most of the time, one should be able to tell the differenct.  I hope that this helps alittle.
Sincerely,
CCF Neuro MD