Cavernous Malformation (Cavernoma)

What Is It?

A cavernous malformation, also known as a cavernous angioma or cavernoma, is an abnormal collection of blood vessels in the brain. It consists of multiple, small dilated sacs which resemble blood vessels but do not have a direct connection with other blood vessels. The physical appearance has been described as resembling a mulberry.

The exact cause of these malformations are not known but some people appear to have a tendency to develop them.

Cavernous malformations can rupture, leading to bleeding into the adjacent brain. Generally, this bleeding tends to be small to moderate as compared to the large amount of bleeding that can be seen from other cerebrovascular diseases such as a cerebral aneurysm or an arteriovenous malformation. A cavernous malformation may increase in size over time, often with evidence of leakage of blood products at multiple times in the past at the time of presentation.

What Types of Symptoms Are Typical?

Bleeding or leakage of blood produces from a cavernoma can be silent or symptomatic. With bleeding, neurological symptoms related to the location of the cavernoma can occur. These vary considerably depending on what part of the brain the malformation is in. A cavernoma in the brain stem can be much more dangerous than a small peripheral lesion in less important parts of the brain.

As the malformation enlarges and irritates the brain around it, particularly if there have been episodes of bleeding in the past, seizures or progressive neurological dysfunction can occur. Again, these vary depending on the location of the lesion.

Headaches are a non-specific symptoms which can occur in some patients.

How Is The Diagnosis Typically Made?

If a patient presents with neurological symptoms, they typically undergo some form of imaging study after a neurological examination. A CT scan or MRI scan can generally detect these lesions and show evidence of bleeding if any has occurred. Cavernous malformations have a quite characteristic appearance on these images and thus the diagnosis can often be made with a high degree of accuracy.

Occasionally, asymptomatic cavernomas can be discovered on a CT or MRI scan incidentally, if the patient gets these tests for another reason.

Interestingly, cavernomas, despite being of blood vessel origin, are not visible on cerebral angiograms, unlike most other cerebrovascular malformations such as cerebral aneurysms or an arteriovenous malformations.

What Are Some Common Treatments?

Treatment varies depending on location, symptoms and size of these malformations. For some patients, they are simply watched and only treated at a later date if symptoms become progressively severe. In those that decide on treatment, surgical removal of the malformation is generally curative. These are not tumors so if removed completely they do not generally recur.

Each case is different so the treatment plan should always be discussed with each patient's own personal physician.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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