Cavernous Malformations

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The tangle of capillaries in a cavernous malformation may leak and create small “caverns” of blood within the brain.

A cavernous malformation (also called a cavernoma, cavernous angioma, or a “cav-mal”) is a rare type of vascular malformation, meaning an abnormality of the blood vessels. A cav-mal can occur in any part of the body, but it’s usually only a threat in the brain or spinal cord. When it occurs in the brain it’s known as a cerebral cavernous malformation, or CCM. 

A CCM consists of a tangle of capillaries (the small blood vessels that carry oxygen-rich blood deep into the brain) in which the vessel walls are thinner and less elastic than normal, and more prone to leaking. That leakage can create small “caverns” of blood within the brain. It occurs equally in women and men and can be diagnosed at any age, but it is most likely to be detected in young adults.

A cav-mal may remain stable for decades and never cause any symptoms at all. Some people only discover that they have a cavernous malformation when they have an MRI scan for some other reason, such as after a car accident or other injury (an “incidental” finding). In those individuals, no treatment at all may be needed.

But a cavernous malformation may begin to leak (hemorrhage) intermittently over the course of months or years. In some people, the cav-mal causes symptoms that get worse with each small hemorrhage, then gradually get better as the leaked blood is reabsorbed, only to worsen again with the next hemorrhage. The malformation usually grows slowly over time, enlarging with each small hemorrhage. (See Symptoms of a Cavernous Malformation.)

In other cases, a cerebral cavernous malformation may cause substantial bleeding in a single episode, with significant hemorrhage leading to severe neurological deficits or even death. If the cav-mal is located in the surface layer of the brain (the cerebral cortex), it may also cause seizures.

The prognosis for a cav-mal is different for each individual, based on the size and location of the malformation and on its tendency to hemorrhage or not.

What Causes a Cavernous Malformation?
Cavernous malformations are thought to be genetic in origin, so they cannot be prevented. They do appear to run in families, although many people diagnosed with a cavernous malformation do not have any family history of the disease.

Cavernous malformations are complicated conditions, and should be treated at major medical centers by experts in cerebrovascular disorders. Use our online form to request an appointment for a consultation or second opinion.

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Reviewed by Jared Knopman, M.D.
Last reviewed/last updated: October 2017
Illustration by Thom Graves, CMI