Cavernomas
A cavernoma, also known as a cerebral cavernous malformation (CCM), is a cluster of abnormal blood vessels that is most commonly found in the brain or spinal cord. These blood vessels form a collection of blood-filled cavities with thin walls that can leak or bleed. Cavernomas may occur sporadically or be inherited as a genetic condition.
Symptoms
Many cavernomas do not cause symptoms and are discovered incidentally during imaging studies. When symptoms do occur, they may include:
- Headaches
- Dizziness
- Seizures or epilepsy
- Personality or behavioural changes
- Problems with memory, concentration, or attention
- Difficulties with balance and co-ordination
- Visual disturbances
- Weakness or numbness in the arms or legs
- Changes in eye function, such as unequal pupil size
- Difficulties performing normal daily activities
Cavernomas can cause bleeding within the brain (haemorrhage). Cavernomas located in the brainstem or other critical areas of the brain can be particularly serious because of their potential impact on vital functions such as breathing and heart rate.
Emergency warning signs may include severe headache, repeated vomiting, sudden neurological deterioration, seizures, or loss of consciousness.
Diagnosis and Treatment Options
Diagnosis typically involves:
- Review of medical history, including signs and symptoms
- Physical and neurological examination
- Blood tests, where appropriate
- Imaging studies such as computed tomography (CT), magnetic resonance imaging (MRI), or, in selected cases, cerebral angiography
A series of non-invasive tests may be performed to determine the presence, size, and location of a cavernoma.
Genetic testing may be recommended for patients with a family history of cavernomas or when an inherited form of the condition is suspected. This may involve a blood sample or a cheek swab to identify genetic mutations associated with cavernous malformations.
Treatment depends on the size, location, and symptoms of the cavernoma. Medications may be prescribed to control symptoms such as headaches or seizures.
In some cases, bleeding from a cavernoma may be reabsorbed by the body without causing significant long-term problems. However, if a large haemorrhage occurs or the cavernoma causes ongoing symptoms, surgery to remove the lesion may be recommended.
Advances in microsurgical techniques have made the treatment of cavernomas safer and more effective. Deep-seated cavernomas within the brain and spinal cord can often be removed successfully when surgery is considered appropriate.
Recovery
People with cavernomas, particularly those who experience seizures, may be advised to avoid certain high-risk physical activities or contact sports. Recovery following surgery varies depending on the location of the cavernoma and the complexity of the procedure.
Patients who undergo surgery will require ongoing follow-up, which may occur every six to twelve months or as recommended by their specialist. Follow-up appointments may include imaging studies and neurological assessments to monitor recovery and detect any recurrence or new symptoms.
