A cavernous angioma (also know as a cavernous malformation or cavernoma) is a type of vascular malformation. Consisting of a low-pressure collection of vein-like vessels in the shape of caverns, cavernous angiomas can occur anywhere in the brain, brain stem or spinal cord.
Cavernous angiomas may cause seizures and frequently leak blood into the surrounding brain. Severe or frequent bleeding may lead to the development of a neurological deficit such as weakness, numbness or double vision. Rarely they may cause a large, life-threatening hemorrhage.
Cavernous angiomas are best recognized on an MRI scan of the brain. They appear as "popcorn"-shaped lesions surrounded by a dark ring made up of old blood from previous leaks. On CT they can be identified as small hemorrhage areas. The malformations are not visible by a conventional angiogram, and for this reason, cavernous angiomas are often referred to as angiographically occult vascular malformations (AOVM).
Microsurgery is the treatment of choice for lesions that are symptomatic and accessible. Surgical removal of a cavernous angioma eliminates the risk of future bleeding. In the case of epilepsy, surgery may cure, or at least reduce, the severity of seizures. Since cavernous angiomas are not visible on an angiogram, endovascular embolization is not possible. It is uncertain whether stereotactic radiosurgery may have a role in the treatment of some deep or inaccessible lesions. At Lahey Hospital & Medical Center, we have considerable experience and special training in the treatment of cavernous angiomas of the brain and spinal cord. Using specialized skull base microsurgical techniques and a computerized image guidance system we are able to safely remove many challenging cavernomas that might previously have gone untreated.