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What is a cavernous malformation?

A cavernous malformation is a small mass that is made up of abnormal, thin-walled blood vessels. These malformations are sometimes called cavernomas, cavernous hemangiomas, or occult vascular malformations. Most cavernous malformations are congenital (present at birth).

Cavernous malformations can occur anywhere in the body, but usually only cause serious problems in the brain and spinal cord. They are one of the more common cerebrovascular problems in children. While many people with cavernous malformations never have any problems, they can cause neurologic symptoms and can sometimes be life threatening.

In most cases, cavernous malformations are not diagnosed unless there are symptoms.

How we care for cavernous malformations

At Boston Children’s Hospital, our expert clinicians in the Cerebrovascular Surgery and Interventions Center treat cavernous malformations and other cerebrovascular conditions.

Cavernous Malformations | Symptoms & Causes

What are the symptoms of cavernous malformations?

Symptoms occur when the cavernous malformation bleeds.

Symptoms can vary depending on where the cavernous malformation is located, but may include:

  • weakness in the arms or legs
  • seizures
  • headaches
  • dizziness
  • irritability
  • changes in personality

These symptoms may appear and then go away as the malformation bleeds and then reabsorbs blood.

What causes cavernous malformations?

The exact cause of cavernous malformations is not well understood, though some types may be inherited. If many family members have seizure disorders or blood vessel abnormalities on the skin, other family members may be at higher risk for a cavernous malformation.

The malformation results when small blood vessels (capillaries) within the brain group into enlarged or irregular masses. Compared to other blood vessels, capillaries have thin walls. So when they stretch out from excessive blood flow, they often cannot return to their normal size.

Head trauma may increase the risk for cavernous malformations to bleed, so doctors recommend that children with cavernous malformations avoid activities and sports with a high likelihood of head trauma, such as football.

Cavernous Malformations | Diagnosis & Treatments

How are cavernous malformations diagnosed?

Cavernous malformations are usually diagnosed and evaluated by using magnetic resonance imaging (MRI) and computed tomography (CT). Unlike most other cerebrovascular conditions, cavernous malformations are difficult or impossible to see on angiograms, because the blood flow within the malformations is very slow and because the vessels feeding them are so tiny.

How are cavernous malformations treated?

Most children who don’t have symptoms will never notice any ill effects of the cavernous malformations and do fine with a "wait-and-see" approach.

If the cavernous malformation bleeds, surgery may be recommended. Surgery is a good option if there is a single cavernous malformation that is clearly the cause of the child's symptoms and is located in a part of the brain that can be easily accessed. Most children have excellent outcomes from surgery.

Expert care for cavernous malformations

Our expert clinicians in the Boston Children’s Hospital Cerebrovascular Surgery and Interventions Center are highly experienced in treating cavernous malformations.

In addition to treating the cavernous malformation itself, we bring together a team to address any neurologic problems it may have caused, including neurologists, physical and occupational therapists, and speech-language therapists.

Learn more about the surgical management of cavernous malformation in this webinar from Ed Smith, MD, director of Pediatric Cerebrovascular Neurosurgery at Boston Children's and the Angioma Alliance.

Cavernous Malformations | Programs & Services