Cavernous angiomas of the central nervous system.

The histopathological, epidemiological, clinical and neuroradiological findings of the cavernous angiomas of the central nervous system have been reviewed, based on an analysis of the literature. C.A. was considered a very rare lesion in the pre-CT era (5% of the vascular malformations). In the past mainly the cavernous angiomas operated on were responsible for a hemorrhagic syndrome or a space-occupying lesion syndrome and less frequently did they present with seizures. Since the introduction of the CT and moreover of MRI the reported cases of cavernous angiomas in the C.N.S. have increased considerably (25.1% of the vascular malformations). Familial cases, multiple localizations, association with tumors and other vascular malformations and extracerebral dural localizations have been documented. Angiographic examination can be negative, but in some cases a capillary blush in the late venous phase has been demonstrated. CT scan and MRI are the best procedures for the diagnosis of cavernous angiomas. MRI is able to demonstrate small and no recent traces of bleeding, but CT is more sensitive in distinguishing calcifications. Surgical results depending on the site of the angioma have been reported. Radical removal and good recovery have been documented in supratentorial cases, while partial removal and poor results have been reported in deeply sited cases (including spinal cord).