A cavernous malformation is also known as a cavernoma. Located in the brain or spinal cord, they are a vascular abnormality that consists of a cluster of abnormally dilated blood vessels. Measuring less than three centimeters, they are normally a reddish to purplish color.
Who gets cavernous malformations
Neither the sex nor the race matters when it comes to who gets cavernous malformations. About the same number of men as women have them. 5,000 out of one million people have at least one cavernoma even though it may not be symptomatic.
Special facts about cavernomas
Cavernomas can be found anywhere in the brain or the spinal cord, and they can be different sizes. A person is not limited to just one. They can actually have several. Since cavernous malformations are not cancerous and do not spread to other parts of the body.
Symptoms of a cavernous malformation
Cavernous malformations may not present any symptoms. Those with symptoms often experience headaches, bleeding, seizures and progressive neurologic deficits. Other common symptoms of a cavernoma are unsteadiness, loss of vision, difficulty speaking, double vision, difficulty swallowing, hearing difficulties, paralysis and weakness or numbness in the legs, arms or face. It is often recurring headaches that lead to diagnostic testing that ends in a diagnosis of a cavernous malformation.
How cavernomas are diagnosed
Doctors use a CAT scan and a MRI to diagnose cavernous malformation. Both of these tests can show pictures of slices of the brain, making it possible for the doctor to see exactly where the cavernoma is located. The MRI can pick up smaller and hidden lesions on the brain.
Since not every cavernous malformation presents symptoms, it is not necessary to treat all of them. If a cavernoma has an episode of bleeding, presents neurological dysfunction, causes uncontrolled seizures or presents intolerable symptoms, it is an indication that treatment should be considered. The doctor will tell the patient what he recommends after it has been diagnosed.
Treatment of cavernous malformations
When considering treatment for a cavernous malformation, there are really only two options. The doctor must decide whether to just leave the cavernoma with no treatment or to surgically remove it. If the patient is older and is not having any problems, the most logical thing to do is to leave it alone.
If a patient is younger and the cavernoma is in a place where it is easily operable, then it would make sense to operate and remove it. By removing the lesions, it may prevent future hemorrhaging, control epilepsy or reduce the worsening of neurologic deficit. The doctor and the patient would need to weigh the complications that might occur with surgery with the benefits of the treatment in order to determine whether or not to go ahead with surgery.
When a cavernous malformation bleeds
25 percent of all patients who have a cavernous malformation will hemorrhage at one time or another. This is the most serious complication that can happen. If a bleed is small, it may not present any symptoms at all.
However, if the bleed is larger, it will usually start with a sudden headache. Nausea follows with neurological problems. The patient's level of consciousness continues to decrease, and he must receive emergency medical care as quickly as possible.