Is a cavernoma serious?

Written by: Mr Ciaran S. Hill
Published: | Updated: 31/10/2023
Edited by: Cal Murphy

Problems with the brain are always a worrying prospect. Our brains are, in a lot of ways, who we are, containing our memories and acting as the control centres of our bodies.

 

A cavernoma is a condition of the blood vessels that can occur in the brain or spinal cord, and can even lead to bleeding in the brain. Are they serious? Leading neurosurgeon Mr Ciaran S. Hill has the answers.

Woman with a cavernoma holding her head

What is a cavernoma?

A cavernoma, also called a cavernous angioma, cavernous haemangioma, or cavernous malformation, is an accumulation of abnormal blood vessels found in the central nervous system – most commonly in the brain and spinal cord. These blood vessels are wide (cavernous, hence the name), and blood travels through them slowly.

 

Cavernomas can range in size from just a few millimetres to several centimetres and usually look similar to raspberries. They are a type of arteriovascular malformation (AVM).

 

As many as 1 in every 600 people could have a cavernoma. The majority of cases are not hereditary and it is unusual to have more than one. However, some cases are thought to stem from a genetic predisposition, particularly in patients who have multiple cavernomas.

 

 

What are the symptoms of a cavernoma?

Most cavernomas do not cause any symptoms, and may go unnoticed for most of (or even all of) the patient’s life. Most are found during scans carried out for other reasons.

However, in some cases they can cause symptoms, which can be very serious in nature and may post a serious risk to the patient’s health. Symptoms can include:

Each case is different, and the symptoms that present depend largely on where the cavernoma is located and how severe it is. Problems tend to occur when the cavernoma is putting pressure on certain parts of the brain or bleeding into it. Most haemorrhages are small and asymptomatic, but severe bleeding can potentially prove fatal, or could have long-term consequences for the patient’s health.

 

What causes a cavernoma?

The exact causes of cavernomas are poorly understood. Most cases seem to occur completely at random, but a minority of cases seem to involve a genetic predisposition.

 

How are cavernomas diagnosed?

MRI scans are generally the most effective test to diagnose a cavernoma, providing a detailed image of the brain and spine. CT scans and angiograms can also indicate the presence of a cavernoma, but show this less clearly than an MRI. The slow blood flow through a cavernoma means that it isn’t visible on an angiogram.

 

How are cavernomas treated?

Treatment varies case by case, depending on the symptoms present, the severity of the symptoms, and the location of the cavernoma. As the majority are benign, conservative treatment is the norm.

 

Watch and wait

If the patient is displaying no symptoms and the cavernoma does not appear to be causing any harm, the doctor will generally recommend no treatment, but will monitor the situation with regular check-ups.

 

Medication

This helps to manage the symptoms, but does not affect the cavernoma itself.

 

Neurosurgery

Treating the cavernoma directly is not a decision that is taken lightly, and is recommended when the risks of not operating outweigh the risks of the procedure. A multidisciplinary team (MDT) of specialists will carefully plan the complex procedure.

 

Non-invasive surgery

Newer technologies such as GammaKnife and CyberKnife offer stereotactic radiosurgery. These non-invasive options may be used for cavernomas located deep in the brain, where invasive surgery carries higher risk or is downright impossible.

The available options are always thoroughly discussed with the patient beforehand, as are the patient’s own preferences.

After a patient has been successfully treated for a cavernoma, they will need regular check-ups with their doctor and further scans.

 

 

 

For more information about cavernomas or to book an appointment, visit Mr Hill's Top Doctors profile.

By Mr Ciaran S. Hill
Neurosurgery

Mr Ciaran Scott Hill is a highly accomplished, consultant neurosurgeon and honorary associate professor with over 15 year’s of experience practising in London. He treats a wide range of neurosurgical conditions and possesses expertise in both benign and malignant (cancerous) brain tumours, brain metastasis, cavernoma and facial pain, alongside gamma knife, radiosurgeryskull base tumours and degenerative and painful spinal conditions.

Mr Hill was awarded an MBBS from Barts and The Royal London Medical School at The University of London in 2007, graduating top of his year group with a double distinction. Following this, he undertook neurosurgical training in London with experience in the full spectrum of cranial and spinal neurosurgery. He also obtained subspeciality training with an academic clinical lectureship in neurosurgical oncology at Queen Square, London.

Mr Hill successfully completed a PhD in clinical neuroscience, from the prestigious University of Cambridge.

He is passionate about advancing patient care and developing new treatments, currently holding the role of honorary associate professor at the Cancer Institute of University College London. In his research, he aims to gain insights into fundamental molecular mechanisms of disease and implement these into patient care. He also strives to support other clinicians and to deliver a world-class service of care to both his patients and students, working to improve understanding and treatment of brain tumours and other diseases of the brain and spine.

Mr Hill has an extensive research output with multiple high-impact peer reviewed publications, abstracts and books. He leads several clinical trials to improve outcomes for patients. He is a fellow of The Royal College of Surgeons and the Higher Education Authority.

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