Abstract
Scleroderma is a rare disease of unknown etiology, which is characterized by thickening and hardening of skin due to an increased collagen production. A 44-year-old female patient with a scleroderma on the scalp known by our department, also presented an ipsilateral brain lesion since 2015, which was showing growth without any clinical symptomatology and the patient wanted the lesion to be removed. This atypical lesion underneath the scleroderma shows that diagnosis can be missed without brain imaging and biopsy.

Introduction
Localized scleroderma encompasses the conditions of linear scleroderma (LS) (extremity and facial), plaque or circumscribed morphea, pansclerotic and generalized morphea. By definition, localized scleroderma involves the skin and the underlying tissue [1]. The most commonly described brain lesions in LS ‘en coup de sabre’ are intracranial calcifications, which are characteristically ipsilateral to the skin lesions and appear as hypo intense white matter lesions on T2-weighted magnetic resonance imaging (MRI) [2-4]. Cerebral angiograms and magnetic resonance angiogram studies may typically show vascular involvement suggestive of vasculitis. Reports of cerebral aneurysms and other vascular malformations, as brain cavernomas [1, 5, 6], exist and could represent late sequelae of a vasculitic process. To our knowledge there have been no case reports published showing a brain carvernous malformation ipsilateral to the scleroderma and beneath it in the adult population. However, we found 2 case reports in pediatric series.