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Cavernous Malformation (Cavernoma)

A cavernous malformation, or cavernoma, is a type of vascular malformation that consists of abnormally thin-walled blood vessels grouped together in the central nervous system (brain and spinal cord). These blood vessels are like little pockets containing blood at a low pressure. A cavernoma looks like a mulberry. Constant leaking of blood often causes symptoms. About 25-30% of people with cavernous malformations in the brain never have problems related to this low-pressure, intermittent bleeding.

There are three types of cavernous malformations:

  • Familial: This form is passed from parent to child. A person who inherits this condition usually has many cavernous malformations. The malformations may be in the brain, on the spinal cord or in both places.
  • Sporadic: This form has no other identified cause. People with this type usually have only one malformation. It is usually in the brain.
  • Radiation-induced: This is not a common form, but some researchers believe that cavernous lesions can develop after having radiation treatment to the brain. When it does happen, it usually happens two to eight years after the radiation treatments.

SYMPTOMS

People with cavernomas in the brain may have the following signs of bleeding, or cerebral hemorrhage:

  • Headaches: These may come and go, could be more frequent, or could happen quickly and be very strong.
  • Seizures:  These are not always related to bleeding. Someone having a seizure could experience confusion, disorientation, loss of consciousness, falling, tongue biting or urinary incontinence.
  • Difficulty with speaking and understanding: This may include slurring words or difficulty finding words.
  • Numbness or paralysis of face, arm, or leg: This could develop suddenly, with new weakness or inability to move and often happens on just one side of the body.
  • Problems walking:  This could include stumbling, sudden dizziness, loss of balance or loss of coordination.

People with cavernomas in the spinal cord may have the following signs of bleeding:

  • Sudden numbness or weakness of both legs
  • Sudden change in bowel or bladder elimination
  • Sudden, severe back pain with no known cause

DIAGNOSIS

The main tests used to diagnose cavernomas include:

  • Computerized Axial Tomography (CT Scan)
  • Magentic Resonance Imaging (MRI)
  • Cerebral Angiogram or Digital Subtraction Angiography (DSA): Cavernomas cannot be seen on a cerebral angiogram so if CT and MRI tests are unable to conclusively rule out a true arteriovenous malformation you may be asked to proceed with an angiogram for diagnosis.

TREATMENT OPTIONS

Possible treatment options available for patients who have a cavernoma include:

  • Surgery to remove the cavernoma
  • Radiosurgery of the cavernoma (not common)
  • Medical observation and/or treatment of symptoms