What is a cavernoma?
A cavernoma (or cavernous malformation) is a collection of abnormal, thin-walled blood vessels, filled with slow-flowing blood. A cavernoma can be located in the brain or spinal cord.
There is often a Developmental Venous Anomaly (DVA) in association with a cavernoma. A DVA represents a variant on normal venous drainage and is benign.
The majority of cavernomas are sporadic. Approximately 1/5 of patients with a cavernoma have a familial form of the disease where cavernomas are often multiple.
Cavernomas can bleed, causing stroke or death. In general the haemorrhage from a cavernoma is relatively small because of the slow flow of blood within the lesion. It’s estimated that the risk of bleeding from a cavernoma is between 1-2 % per year. Cavernomas may also cause seizures or may remain asymptomatic.
In general, asymptomatic cavernomas discovered incidentally do not require treatment. If a cavernoma causes seizures the patient is managed with anti-epileptic medications. Surgery becomes an option if the seizures are not controlled with anti-epileptics or if the cavernoma causes a symptomatic haemorrhage.
Surgery can be risky if the cavernoma is located in eloquent brain. The risk of surgery as well as the lifetime risk of stroke or death if the lesion is not removed must be taken into consideration on an individualised basis.
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