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The Cerebrovascular Surgery and Interventions Center treats cavernous malformations and other cerebrovascular conditions.
A cavernous malformation (CM), also called a cavernoma, cavernous hemangiomas or occult vascular malformations, is a small, berry-like mass that consists of an abnormally expanded, thin-walled blood vessel. It can range in from dime-sized to 3-5 inches or greater. Cavernous malformations can occur anywhere in the body, but usually only cause serious problems in the brain and spinal cord. It is among the more common cerebrovascular problems in children. While many people with cavernous malformations never notice any ill effects, they can cause neurologic symptoms and can sometimes be life-threatening. Most cavernous malformations are congenital (present at birth).
Most cavernous malformations are diagnosed after they have become symptomatic, by causing bleeding (hemorrhage) in the brain. The hemorrhage can be small and intermittent (subacute) or it can be large and rapid, causing a sudden onset of symptoms. Symptoms will vary depending on the cavernous malformation’s location, but may include:
In most cases, symptoms gradually lessen as the blood becomes resorbed. In some cases, where the hemorrhage is large and exerts significant pressure on the brain, the child will have a faster recovery and a better outcome if the cavernous malformation is surgically removed.
How we care for cavernous malformations at Boston Children’s Hospital
In deciding how to treat cavernous malformations, we carefully evaluate each child with noninvasive head and neck imaging. If the cavernous malformations are not causing symptoms, many children do fine with a “wait-and-see” approach. If a cavernous malformation has begun to bleed, we are more likely to recommend surgery if it is clearly the cause of the child’s symptoms. Surgery is the option of choice if there is a single cavernous malformation in an accessible part of the brain that can be operated on safely. While some centers use stereotactic radiosurgery, we use it only as a last resort. After treatment, we follow each child every six months or annually with magnetic resonance imaging.
In addition to treating the cavernous malformation itself, Boston Children’s Hospital addresses any neurological symptoms it may have caused and provides close support to help children and families cope with any resulting disability.
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