What is a Cavernoma?
A cavernoma or cavernous malformation is a vascular abnormality of the central nervous system. It consists of a cluster of abnormal, dilated vessels. Pathologically, it is red to purple in colour, appearing as a raspberry. Cavernomas contain blood products at various stages of evolution and are usually less than 3centimetres in size.
What are the Causes of Cavernous Malformations?
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.
Who Gets a Cavernous Malformation?
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.
What are the Symptoms of a Cavernous Malformation?
- Seizures
- Progressive or transient neurologic deficits
- Bleeding
- Headache
It is important to know that a cavernous malformation can be present and not produce any symptoms.
Headaches and Cavernous Malformations:
Headaches accompany a cavernous malformation in many patients and may have even precipitated the diagnostic evolution uncovering the lesion. 6 – 10% of patients with a cavernoma will report headaches as an accompanying symptom.
Progressive or Transient Neurologic Deficits:
Patients may present with double vision, unsteadiness, sensory disturbances, and weakness of 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.
Seizures and Cavernous Malformations:
Sometimes patients present to emergency with a seizure and upon investigation of the seizures a cavernous malformation is found. 36% of patients with a cavernous malformation will present with seizures.
Bleeding from a Cavernous Malformation:
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.
