Cavernous Venous Malformation(Archived)

Cerebral cavernous malformations, also known as cavernomas or cavernous hemangiomas, are clusters of abnormal and hyalinized capillaries without intervening brain tissue (see  Pons Cavernoma, Head CT, Cavernous Malformation). Due to recurrent microhemorrhages and thrombosis, they are typically surrounded by hemosiderin deposits and gliosis. These lesions have slow flow and low pressure, causing the average rupture risk to be much lower than that of some other vascular malformations, such as arteriovenous malformations. Cavernomas are often found incidentally, but can also present during evaluation of headaches, seizures, focal neurologic deficits, or symptomatic hemorrhage.  aSupratentorial location is the most common, though lesions in the basal ganglia, brainstem, cerebellum, and spine also can occur. They can be associated with developmental venous anomalies (DVAs). The average annual rate of hemorrhage is reported at 0.7%-1.1% per lesion in patients without a history of prior hemorrhage. This risk rises to approximately 4.5% in patients who have sustained previous intracerebral hemorrhage. Approximately 2-3 years after a hemorrhagic event, the risk of hemorrhage is thought to decrease. Rupture risk is also dependent on the cavernoma's location, presence of associated developmental venous anomaly, and gender. Infratentorial location, deep location, young age, and female gender are associated with increased risk., Asymptomatic familial cases are also thought to have a higher annual hemorrhage rate than asymptomatic sporadic cases. Cavernous malformations may also arise de novo. They may grow, shrink, or remain stable over time.