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Cavernomas of the CNS : Basic Science to Clinical Practice

Publication at First Faculty of Medicine |
2020

Abstract

Cavernomas (also known as cavernous malformations, cavernous hemangiomas, or cavernous angiomas) are vascular hamartomas made up of thin-walled, grossly dilated blood vessels lined with endothelium. There is no smooth muscle within the blood vessel walls, and there is a lack of intervening brain parenchyma.

Although the brain is the most common site for these lesions, cavernomas may occur virtually in any organ. The prevalence within the population is approximately 0.6 per 100,000, which puts them among the most common vascular malformations of the brain.

In recent years, significant contributions to the pathophysiology, biology, and genetics of these lesions have been made. Although there has also been significant development in the neuroimaging and active treatment techniques, especially surgical resection, observation alone is still a useful management strategy for some cavernomas.

The decision to perform surgical treatment in each individual case depends on many features of a particular lesion, namely its anatomical location, eloquence of adjacent brain tissue, and type of presentation. Moreover, the natural history of the disease must be taken into account and compared to the possible benefits of surgical treatment.