A cerebral cavernous malformation is an abnormal group of small blood vessels that may be found in the brain and spinal cord. These lesions can be quiet for many years, later manifesting as bleeding.
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What Is Cerebral Cavernous Malformation?
Cerebral cavernous malformations (also known as cavernous angiomas or cavernous hemangiomas) are clusters of small blood vessels that can form into lesions around the brain and spinal cord. They can vary in size and depth from a few millimeters to centimeters, and they can increase or decrease in number over time. Cerebral cavernous malformations may cause serious neurological symptoms — even death — as a result of severe bleeding or pressure on the brain or nerves.
Some cases of this condition can be asymptomatic, but there is still potential for hemorrhage. That is why people who have cerebral cavernous malformations should avoid certain medications, like NSAIDS, that can thin the blood. While these lesions are often low-flow, they may never bleed or may bleed at a slower rate than a large hemorrhage.
Many cases of this condition can lead to seizures that can be controlled with anti-epileptic drugs, but the potential exists for bleeding and more severe symptoms.
How common is cerebral cavernous malformation?
Cerebral cavernous malformations are uncommon, only occurring in about 0.4% to 0.8% of the general population. There is no difference in the occurrence rate between men and women, and the condition is detected in both adolescents and middle-aged adults.
What causes cerebral cavernous malformation?
The direct cause of cerebral cavernous malformations is still unknown, but there seems to be a family predisposition for this condition.
Cerebral cavernous malformation risk factors
The main risk of a cerebral cavernous malformation is that it can begin to bleed. The likelihood of continued bleeding and increased severity of bleeding only gets higher with time and more instances of bleeding.
Complications of cerebral cavernous malformation
Left undiagnosed or untreated, this condition can have a serious impact on your health and well-being. Cerebral cavernous malformations can lead to cerebral hemorrhages, headaches, paralysis, seizures, and thrombosis. Any of these effects can lead to death in severe cases.
What Are the Signs and Symptoms of Cerebral Cavernous Malformation?
Your physician will ask you about your symptoms, which may include:
- Cerebral hemorrhage (bleeding in the brain).
- Headaches.
- Hearing or vision changes.
- Paralysis.
- Seizures.
When should I see a doctor about my cerebral cavernous malformation symptoms?
If you experience any of the symptoms associated with cerebral cavernous malformations, you should see your doctor immediately or go to your local emergency room.
How Do You Diagnose Cerebral Cavernous Malformation?
The symptoms of cerebral cavernous malformations can be similar to other conditions that affect the brain or brain stem. The only way for doctors to diagnose your condition is to use imaging technology like a CT or MRI scan.
Tests to diagnose cerebral cavernous malformation:
- Angiography — Doctors introduce a radiopaque substance into the bloodstream to view how it passes through the body, especially the lesions of the cerebral cavernous malformations.
- CT Scan — Computed tomography scan uses computer imaging and x-rays to make a detailed image.
- MRI Scan – Magnetic resonance imaging uses magnets and radio waves to create an image of the interior of the body.
How Do You Treat Cerebral Cavernous Malformation?
The goal of treatment for cerebral cavernous malformations is to prevent the possibility of internal bleeding by eliminating the cavernous lesions. Lesions can be eliminated either through Gamma Knife radiosurgery treatments or traditional surgery to remove the lesions.
At UPMC, resection of a cavernous malformation is also performed using intraoperative guidance such as:
- MRI.
- High-definition fiber tracking (HDFT) technology — Shows a 3-D image of the brain filled with thin, brightly colored strands that correspond to the different functions of the brain's major fiber tracts.
- Magnetoencephalography (MEG) — a noninvasive brain imaging technique that measures magnetic fields produced by brain activity.
What happens/during Gamma Knife radiosurgery?
Gamma Knife radiosurgery is a painless treatment that uses hundreds of highly focused radiation beams to target tumors and lesions within the brain, with no surgical incisions.
The Gamma Knife may be indicated for deep-seated cavernous malformations that repeatedly bleed and are not easily accessible for microsurgical removal. The goal is to reduce the risk of additional bleeding events while maintaining existing neurological function.
As the nation's leading provider of Gamma Knife procedures, UPMC has treated more than 18,000 patients with tumors, vascular malformations, pain, and other functional problems.
How effective is treatment?
Over its 30-year history at UPMC, Gamma Knife radiosurgery has proved effective for more than 18,000 people with:
- Benign or malignant brain tumors.
- Pain.
- Vascular malformations.
- Other functional problems.
How long does it take to recover after surgery for cerebral cavernous malformations?
Although the surgery itself can be quick and painless, there will be a necessary recovery period.
Side effects of this treatment include:
- Fatigue.
- Headache.
- Nausea and vomiting.
- Swelling in the treated area.
- Tenderness and bruising where the head frame was attached to your scalp.
