What is a cavernous malformation?

A cerebral cavernous malformation (CCM), or a central nervous system angioma, refers to an expanded and asymmetrical group of capillaries or tiny blood vessels. The capillary walls within a CCM are less elastic than usual, thinner in comparison, and more susceptible to leakage. The cavernous malformations occur anywhere in the body. Once they are located in the brain and spinal cord, they present with symptoms most frequently.

It is made up of collections of blood vessels in sizes ranging from less than 1/4 inch to 4 inches. Seizures and headaches are common symptoms. The number and location of lesions dictate what kind of symptoms is experienced.

What symptoms of a cavernous malformation exist?

Symptoms may include:

• Loss of balance.
• Loss of vision, double vision, or loss of clear vision.
• Inability to control urine and bowels.
• Dizziness.
• Fatigue.
• Headache.
• Loss of hearing.
• Memory loss.
• Seizures.
• Slurred speech.
• Tremors.
• Weakness or numbness in the arms or legs.

They often appear between 20 and 60 years of age. In many instances, you do not feel anything at all. If there are symptoms, the cavernoma is probably bleeding. Sometimes you might not experience symptoms at all while it bleeds. The severity differs according to the size and position.

What causes a cavernous malformation?

Most cavernous malformations are of unknown cause. A mutation in one of the following genes is responsible for nearly 20% of cases, which are hereditary in nature:

• CCM1 (KRIT1).
• CCM2, CCM3, and PDCD10.

These genes produce proteins that are also referred to as junctions that attach blood vessel cells together. The haemangiomas will arise due to the genetic change, which decreases the strength of cell junction.

Are cerebral cavernous malformations hereditary?

There are a number of cavernous abnormalities that are inherited. It is more common for individuals with a familial history to have multiple cerebral cavernous haemangiomas.

Inheritance (autosomal dominant)

You can inherit one copy of the gene variation from a biological parent. If you do, your children have about a 50% chance of developing a haemangioma.

However, most of the cases are rare, and they happen randomly, and there is no family history of the condition in your biological family.

What are the risk factors for cavernous malformation?

A cerebral cavernous malformation might be more likely to occur if you:

• Possess developmental venous anomalies (dvas), another kind of aberrant blood vessel.
• Had radiation treatment for your spine or brain.
• Has a history of cavernous haemangiomas in their biological family.

How would you diagnose a cavernous malformation?

A cerebral cavernous malformation would be diagnosed by a doctor after an examination and tests. While performing a physical examination, your doctor will take you through the symptoms. They may offer you a genetic test to identify the genetic variation that caused the cavernoma. To get a better view of the deformity and check for any bleeding or swelling, your doctor may also recommend an MRI.

Susceptibility-weighted imaging is a type of MRI scan that your doctor may prescribe. This type of MRI is more sensitive. It detects faint marks of previous bleeding as well as the smallest cavernous haemangiomas. Your care team can better evaluate the likelihood of future problems with the use of this information.

Cerebral cavernous malformations are often not diagnosed by providers until they rupture and bleed. You can have a cavernoma without any symptoms, however. In that case, if you had a brain scan for another reason, your doctor would diagnose it.

What is the treatment for a cavernous malformation?

Treatment for cavernous malformations varies depending on their location, whether they are bleeding, and whether they are causing symptoms.

Your provider may also schedule periodic imaging tests to monitor the cavernoma periodically if it is not bleeding. Between appointments, you'll also learn what the bleeding symptoms are and when you should contact your provider if a bleed has occurred.

If the cavernous malformation has started to bleed, your provider may recommend one or more of the following interventions:

• Medications to treat headaches or seizures.
• Surgical removal.

Your doctor may consider surgery if:

• You have had at least one episode of symptomatic bleeding.
• Neurologic problems (such as weakness or vision problems) were caused by the bleeding, and they are getting worse.
• You have seizures that are not controlled by medication.
• Surgery is safe for you.

Is it possible to avoid a cavernous malformation?

The prevention of cavernous malformations is unknown. To help you learn more about this illness, your provider will discuss genetic testing and genetic counseling if you have a family history of these haemangiomas.

How can I decrease the likelihood that a cavernous malformation would rupture or bleed?

While it is impossible to prevent every cavernoma rupture or bleed, you can reduce your risk by keeping your overall health in good condition. You can do this by:

• Keeping your blood pressure, cholesterol, and blood sugar levels in good condition for you and your body.
• Discussing all the medications that you are under with your physician to know whether they increase the risk of blood bleeding, particularly blood thinners.
• Engage in physical activities for at least half an hour on most days of the week
• Avoid tobacco use
• Visiting a doctor often and contacting him/her in case of any doubts or concerns.

What is the prognosis for a deformity of the cavern?

Although they are rare, cerebral cavernous malformation ruptures and bleeding can happen. In fact, a study has found that if you have a bleed, your chances of getting one each year are 2.4%.

There are options for treatment. Although surgery does come with some risks, if your doctor can safely reach the brain cavernous malformation, the procedure usually has a good outcome.

Your doctor will discuss the need for follow-up MRI scans with you if you have multiple haemangiomas or if one of them is bleeding or causing symptoms.

When should I come to the emergency room?

Call emergency services immediately if you see any of these signs of cavernous malformation, such as a first seizure, one-sided weakness, or sudden changes in vision. Because symptoms may signal bleeding, potentially leading to stroke, you need to get treated right away.

What questions should I ask my healthcare professional?

• Do I need surgery?
• What are risks of surgery?
• How can I take care of myself without rupturing?
• Does the cavernous malformation affect any drugs I presently take?

Why Tender Palm Super-Speciality Hospital for cavernous malformation?

Tender Palm Hospital, owned by doctors, is renowned for attracting the most experienced professional in the country, with the finest neurologist and neurosurgeons specialized in cavernous malformation. Tender Palm stands out as the premier Neurology hospital in Lucknow, India. Boasting cutting-edge infrastructure and advanced technology, Tender Palm ensures top-notch medical care for its patients.

To seek an expert consultation for any Neurology condition

Call us at +91-9076972161
Email at care@tenderpalm.com

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