Cavernomas
#1
A Cavernoma or Cavernous malformations are a vascular abnormality of the central nervous system involving clusters of abnormal, tiny blood vessels, and larger, stretched-out, thin-walled blood vessels filled with blood in the brain. These blood vessel malformations can also occur in the spinal cord, the covering of the brain (dura), or the nerves of the skull. Pathologically, it is red to purple in color, appearing as a raspberry. Cavernomas contain blood products at various stages of evolution and are usually less than 3 centimetres in size.

Some individuals are born with a tendency to develop cavernous malformations. They are not a cancer, which means they cannot spread to other parts of the body. Occasionally, people can have multiple cavernomas.  Cavernous malformations occur in people of all races and sexes. The male-female ratio is about equal. Family history may be positive especially in patients of Hispanic descent. Recent work has linked the predisposition to cavernous malformation to the seventh human chromosome. Cavernomas can be found in any region of the brain, be of varying size, and present with varying clinical disorders. In a general population of 1,000,000 - .5% or 5000 people may be found to have a cavernous malformation, although many are not symptomatic.

Patients with cavernomas may have associated seizures, progessive or transient neurologic deficits, bleeding, and headaches.   Approximately 12% of patients at our clinic are asymptomatic. Headaches accompany a cavernous malformation in many patients and may have even precipitated the diagnostic evaluation uncovering the lesion. 6-10% of patients with a cavernoma will report headaches as an accompanying symptom.  Patients may present with double vision, unsteadiness, sensory disturbances, and weakness or paralysis on one side of the body. These complaints are closely related to where the lesion is located. 20% of patients will complain of these when they present to the physician.  36% of patients with a cavernous malformation will present with seizures. Up to 25% of patients will present with a hemorrhage. This is the most serious complication of a cavernoma. If the cavernoma does bleed, it usually, but not always, starts with a headache. The headache starts suddenly and may be followed by nausea, neurological problems or a decreasing level of consciousness. Sometimes a bleed may be very small and produce very mild or no symptoms at all.  Bleeding risk depends on where the malformation is located. Deep lesions in the brainstem bleed and cause problems at a rate of 10% per year, whereas symptomatic hemorrhage from a superficial lesion is very uncommon. The risk with a superficial lesion is much lower (less than 1% year). 

There are two main tests that are used to diagnose cavernomas. These are: Computerized Axial Tomography (CAT Scan), Magnetic Resonance Imaging (MRI).  There are two possible options available for patients who are found to have a cavernous malformation: Surgery, or No treatment.  The following are indications to consider treatment of a cavernous malformation: Neurological dysfunction, An episode of bleeding, Intolerable symptoms, Uncontrolled seizures.
                

http://brainavm.oci.utoronto.ca/malforma..._index.htm
"They that are whole have no need of the physician, but they that are sick" -  Jesus of Nazareth
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"They that are whole have no need of the physician, but they that are sick" -  Jesus of Nazareth
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