Cavernous malformations: natural history, diagnosis and treatment

Abstract

Cavernous malformations (CMs) consist of dilated vascular channels that have a characteristic appearance on MRI. CMs are usually found intracranially, although such lesions can also affect the spinal cord. Individuals with CMs can present with epilepsy and focal neurological deficits or acute intracranial hemorrhage. In many cases, however, patients with such lesions are asymptomatic at diagnosis. Furthermore, several natural history studies have documented that a substantial proportion of asymptomatic CMs follow a benign course. Surgical resection is recommended for CMs that require intervention. Radiosurgery has been advocated for many lesions that have not been easily accessible by conventional surgery. The outcomes of radiosurgery and surgery for deep lesions, however, vary widely between studies, rendering treatment recommendations for such CMs difficult to make. In addition to reviewing the literature, this article will discuss the current understanding of lesion pathophysiology and explore the controversial issues in the management of CMs, such as when to use radiosurgery or surgery in deep-seated lesions, the treatment of epilepsy, and the safety of anticoagulation.

Safety of Thrombolysis in Patients With Acute Ischemic Stroke and Cerebral Cavernous Malformations

“…2 The higher frequency of CCMs in our cohort may be explained by use of a 3-T MRI with T2* sequence, which increases the sensitivity for detecting CCMs. 8 We additionally identified 11 patients with CCMs in MRI after initial CT-based thrombolysis. However, because inclusion of these patients into the analysis could introduce a bias, we decided not to include them in our main analysis.…”

Neurocysticercosis, familial cerebral cavernomas and intracranial calcifications: differential diagnosis for adequate management

“…Cavernous malformations are common cerebrovascular abnormalities, affecting 0.4-0.8% of the general population 13,14,15 . Pathologically, CCM are defined by clusters of dilated capillary cavities, in back-to-back disposition, lined by a single layer of endothelium, lacking smooth muscle and no intervening brain parenchyma 16 ( Figure 1).…”

Cavernous malformation of the optic pathway mimicking optic glioma: a case report

“…Cavernous malformations (CMs) are the second most common type of vascular lesion and account for 10-15 % of all vascular malformations [2]. The incidence of CMs ranges from 0.4 to 0.6 % of the population, with a male-to-female ratio of 1:1.…”