What is a cavernous malformation?
A cavernous malformation – also sometimes referred to as a cavernoma, cavernous angioma or cav mal – is an abnormal cluster of thin-walled vessels, which can be located in the brain or in the spinal cord. Most cavernous malformations are sporadic – or randomly occurring – but in some cases, cavernous malformations may be hereditary. Individuals with certain genetic mutations (CCM1, CCM2, CCM3) have an increased risk of developing cavernous malformations, and in some cases, may develop multiple cavernous malformations.
Symptoms
Many cavernous malformations are asymptomatic and identified incidentally, meaning that they are found on a CT scan or MRI that was obtained for unrelated reasons. In some cases, cavernous malformations may cause seizures, or other neurologic symptoms related to the location of the malformation within the brain or spinal cord. More rarely, cavernous malformations may cause bleeding in the brain or spinal cord, which may cause a variety of symptoms depending on the location of the bleed.
Diagnosis
As described above, many cavernous malformations are diagnosed incidentally, on a CT or MRI scan obtained for unrelated reasons. In other cases, cavernous malformations may be found during workup for seizures, or after a patient presents with bleeding in the brain or spinal cord.
Treatment Options
Many cavernous malformations do not require any treatment at all; however, it is essential that any patient with a new diagnosis of cavernous malformation be evaluated by a cerebrovascular-specialized neurosurgeon.
Management may include surveillance imaging only to ensure that the cavernous malformation remains stable. However, depending on the size and location of the cavernous malformation, the patient’s symptoms, and a variety of patient-related factors (age, medical comorbidities, patient preference, etc), some cavernous malformations do require treatment, which typically involves surgical removal. If a cavernous malformation causes seizures, an epilepsy-neurologist will be consulted to help manage those seizures with medications. In those cases, surgery would be considered if the seizures cannot be controlled with medications alone.
How Can We Help You?
The multi-disciplinary team at The Hartford HealthCare Neurovascular Program offers the full spectrum of care for patients with cavernous malformations, from diagnosis, to treatment, to lifelong follow up and support. Our experienced team of specialists includes fellowship-trained neurosurgeons, vascular- and epilepsy-specialized neurologists, neuroradiologists, neuro-intensivists, and subspecialized physician assistants, advanced practice registered nurses, and therapists.