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A cavernous malformation (CM) is an abnormal cluster of capillaries and venules (tiny blood vessels) that periodically bleed and give rise to a "popcorn-like" lesion in the brain or spinal cord with very thin walls that contains blood of different ages. CMs are also known as cavernomas, cavernous angiomas, cavernous hemangiomas or capillary hemangiomas.
CMs can be hereditary, which means that they have been passed from the parents to their children. Most CMs declare themselves by causing seizures, headaches or a major bleeding episode. Less than one percent of people are born with a brain or spinal cord lesion that eventually becomes a CM.
We typically first find the CM in a computed tomography (CT) scan, or more commonly in a magnetic resonance imaging (MRI) scan. The appearance of the cavernous malformation on the MRI is very characteristic. An angiogram is usually not necessary.
Most CMs do not require surgical treatment, but for those patients who do need surgery, the Johns Hopkins cerebrovascular team treats CMs by microsurgical resection. We perform a craniotomy and use a microscope, remove the CM from the brain or spinal cord. We do not recommend stereotactic radiotherapy (also called stereotactic radiosurgery) as a treatment for CMs.
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