Brain Cavernous Angioma

Definition

Definition of Brain Cavernous Angioma
Brainstem cavernous angiomas have recently received a great deal of attention due to enhanced imaging techniques and the realization that even small hemorrhagic events can cause significant neurological deficits. While the majority (approx. 75%) of cavernous angiomas occur in the upper (“supratentorial”) region of the brain, about 1 in 5 are located in the brainstem or in highly sensitive (“eloquent”), lower (“infratentorial “) areas of the brain.

Symptoms

Symptoms of Brain Cavernous Angioma
The most common symptom for brainstem lesions is focal neurological deficit as opposed to seizure or headache for lesions located in surpratentorial regions.

Causes

Causes of Brain Cavernous Angioma
While the root cause of a cavernous angioma hemorrhage is not yet understood, there are some consensus guidelines relating specifically to brainstem cavernous angioma case management:

Watch and wait (“conservative” case management). This consists of routine, periodic MRIs to monitor the changes in the lesion. As long as the lesion appears stable and there are no additional symptoms or evidence of hemorrhage, this is usually the most prudent course of action.

Diagnosis

Diagnosis of Brain Cavernous Angioma
Consult with your doctor.

Treatment

Treatment of Brain Cavernous Angioma
Observation: Your doctor will monitor your cavernous malformation with yearly MRI (magnetic resonance imaging) scans to see if the malformation changes. Your doctor may recommend observation if your malformation is found during tests for other conditions and isn't causing problems.

If you're not experiencing symptoms from the malformation, you may require an MRI every one to two years to monitor your condition. In some situations, repeat imaging may not be required.

Surgery: If your symptoms result from a malformation that can be reached surgically, your doctor may recommend surgery. If your malformation is hard to reach, your doctor may continue observation and recommend surgery only if you have multiple bleeding events or your symptoms worsen.

Stereotactic Radiosurgery: On rare occasions, doctors may use stereotactic radiosurgery (targeted radiation) to treat malformations causing repeated bleeding in areas of the brain that can't be treated with surgery. This may decrease the repeat hemorrhage rate. However, radiosurgery hasn't been shown to completely eliminate malformations.

Prognosis

Prognosis of Brain Cavernous Angioma
Consult with your doctor.

Prevention

Prevention of Brain Cavernous Angioma
Consult with your doctor.