Cavernomas are clumps of enlarged blood cells that can cause bleeding and affect brain function. Symptoms include limb function changes, headaches, and seizures. Treatment options include surgery and stereotactic radiosurgery, but doctors may only intervene if problems arise.
A cavernoma is also called a cavernous angioma or hemangioma. The names refer to a condition in which people have a clumped group of blood cells, usually in the brain or brainstem, that are enlarged or dilated and may get larger over time. About one in 200 people have a cavernoma or more, and sometimes they are completely asymptomatic. However, because the cavernoma can grow, a couple of things can happen over time. They may bleed from time to time and it can start to affect brain function.
Symptoms that a cavernoma is bleeding and creating problems can come on gradually or quickly. People might have changes in the function of their limbs, usually on one side of the body. Some people experience severe headaches and others are likely to have seizures. In some circumstances people have noticed changes in mood or behavior as the cavernoma affects function.
In most cases, cavernous angioma symptoms would be enough to warrant computed tomography (CT) or magnetic resonance imaging (MRI). This is fortunate because both types of scans usually detect the presence of one or more of these lesions. Deciding how to treat is not so simple.
Sometimes the cavernoma is in an area that is easy to access and removal of the lesion would not be problematic. Yet this still means having brain surgery done, and if a person recovers from the symptoms associated with the bleeding, there may be a reluctance to have the lesion removed. Other times the symptoms become so severe that removal is absolutely indicated, but if the cavernous hemangioma is in a hard-to-reach area of the brain, surgical removal can be very difficult or nearly impossible. Also, in rare cases, people may have multiple lesions instead of just one, making it difficult to determine which particular lesion is causing the problem.
One treatment that raises controversy in the medical community is stereotactic radiosurgery. This uses radiation in a treatment at the site of the cavernoma to attempt to destroy it. Most doctors recommend using it only if all other options fail, as it is not always effective and can cause serious side effects. The use of radiosurgery is normally considered more if a lesion is in an area of the brain that cannot be reached with typical surgical methods (scalpel).
Many people don’t need surgery for a cavernoma. Even people who have several of them can live quite normal lives. Doctors usually take the vigilance approach and may only intervene if problems start to arise.
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