Cavernous Malformation

A cavernous malformation (CM) is also referred to as a cavernous angioma, cavernous hemangioma or simply cavernoma. A CM physically resembles a mulberry. They are composed of microscopic, dilated, blood-filled channels and caverns lined by capillary-like vessel walls. Their size can vary greatly. They may be found in the brain and spinal cord.

With the increasing use of brain imaging, up to 50% of cavernomas are found by chance. The rest come to attention because of symptoms or a family history of CM.

Cavernomas located in the brainstem are fortunately uncommon. Their course is more unique and management is more complicated.

When a CM comes to attention clinically, it is most often due to a seizure, hemorrhage or new neurological problem. The specific symptoms are often related to its location.

Hemorrhage from a CM is not typically life-threatening. The risk for hemorrhage from a CM discovered by chance is very low—just a fraction of a percent yearly. However, the risk for hemorrhage in the inherited form is higher, due to the increased number of cavernomas.

About 80% of cavernomas occur randomly (sporadic form). They are often associated with an architecturally distinctive vein (called a venous angioma or developmental venous anomaly). Another 20% of patients have the familial form. Most of these patients have a mutation in one of three genes which can then be passed on to their children. In the familial form, patients often have numerous cavernomas.

Cavernomas may also develop following radiation therapy to the brain.

CM may be suspected based on your history, or it may be discovered completely by chance. Diagnosis is established through the use of one or more of the following tests: magnetic resonance imaging ( MRI ), CT scan or genetic testing in the case of gene mutations or questionable family history.

There are a few primary treatment options for cavernomas: