Cerebral cavernous malformations: Prevalence of cardiovascular comorbidities and allergic diseases compared to the normal population

Abstract

Background To determine the prevalence of cardiovascular comorbidities and allergic diseases in patients with cavernous malformations of the central nervous system compared to the normal population. Methods Clinical and magnetic resonance imaging data of 1352 patients with cerebral cavernous malformations (CCM) from an observational, cross‐sectional, single‐institutional study were analyzed and compared to an age‐and‐gender stratified and matched sample from a population‐based, epidemiological study assessing cardiovascular risk factors in the local normal population of the same area (RECALL study). Results Of 1352 patients, 810 (60%) were female. Mean age was 40.4 ± 16 years. 221 patients (16%) suffered from familial disease. Presence of cardiovascular risk factors and intake of certain drugs in the overall cohort was mostly equal to the normal population reference sample (n = 786). The prevalence of allergic diseases was found to be significantly higher in all CCM patients compared to the normal population (30% vs. 20%, odds ratio [OR] 1.35 [1.12–1.63]) and in sporadic CCM cases compared to the normal population and familial cases (32% vs. 20% (OR 1.46 [1.19–1.78], p = 0.0001) and 22% vs. 20%, respectively). Conclusions We present novel data on CCM using a large single‐institution and population‐based setup. The study elaborates disease characteristics of CCM patients in detail. For the first time, evidence for an unexplained high prevalence of allergic diseases in this patient population is described (differing between sporadic and familial cases), supporting the hypothesis that immune response is involved in the pathogenesis of CCM.

Prevalence of Retinal Venous Malformations in Patients With Cerebral Cavernous or Arteriovenous Malformations

“…Each evidence tier was well matched in terms of demographics and comorbid conditions (Table 1). The average age when initial cerebral imaging was performed at our institution was 54 years for all groups, higher than the mean ages of diagnosis for cavernous malformations (40 years) 7 and arteriovenous malformations (31 years) 8 reported in previous literature. Each group was approximately 60% female and identified as Caucasian in 67% of patients.…”

“…In addition, the mean age of diagnosis is 31-40 years of age for high-risk CVMs. 7,8 In patients aged 70 years and older (1 SD above the mean) with RVMs, we do not recommend neuroimaging because there is a high likelihood that a high-risk CVM would already have been identified. In patients aged 40-70 years with RVMs, we recommend the ophthalmologist participate in shared decision-making with patients.…”

Intramedullary cavernous: a diagnosis to remember

“…Cavernomas are considered rare, with an estimated prevalence of 0.5% of the population, but they represent the second cerebral malformation, after arteriovenous malformations [6]. They can occur throughout the neuroaxis, and the intramedullary form is also considered an uncommon location, corresponding to approximately 5.0% of intramedullary lesions [6].…”