Cavernoma, also known as cavernous angioma, cavernous hemangioma and cerebral cavernous malformation (CCM), is a condition consisting of clusters of abnormally dilated thin-walled blood vessels. The clumped blood vessels are most often found in the brain and spinal cord; far fewer are found in other parts of the body including the skin and the retina of the eye.
Sometimes patients have only one of these clumps but sometimes they may have several. The size of the lesions can vary, ranging from being barely visible to the naked eye to a few inches in diameter.
Cavernomas are often described as looking like a raspberry because they are made up of many bubble-like structures called caverns that are filled with blood. The bubble-like caverns are grossly dilated thin-walled vessels that leak due to defects in their walls.
Incidence of Cavernomas
Estimates suggest that cavernomas occur in approximately 1 out of every 100 to 200 people, roughly in .5 to 1 percent of the general population.
- Children under 20 years of age: 25 to 30 percent
- Adults ages 20 to 40: 60 percent
- Adults over 40: 10 to 15 percent
It is thought that more than 30 percent of people with cavernomas eventually develop symptoms.
Symptoms can vary widely and sometimes come and go, but they may include the following:
- Weakness in the arms or legs
- Vision problems
- Balance problems
- Memory and attention problems
Types of Cavernomas
Sometimes cavernomas are hereditary; this form of the condition is often associated with multiple cavernomas. Although this kind can happen in any family, it occurs at a higher rate among Mexican-American families because of a specific genetic mutation that has been found in this group. Each child of someone with the familial form has a 50 percent chance of inheriting the problem.
Associated venous angioma
Up to 40 percent of solitary cavernomas may develop in the vicinity of another blood vessel abnormality called a venous angioma. Venous angiomas, also known as venous malformations or deep venous developmental anomalies (DVAs), usually don’t create problems unless they are close to cavernomas and consequently make it difficult to surgically remove the nearby cavernoma.
Cavernomas are not visible on an angiogram because blood flows through the lesion slowly. This is one quality that makes cavernous angiomas different from arteriovenous malformations in which the blood flow is strong and fast and so are readily visible in an angiogram.
Risk of hemorrhage
The risk of hemorrhage is related to the location and number of cavernomas that are present. The higher the number, the greater the chance of one or more hemorrhages occurring sometime over a lifetime. On average, cavernous angiomas that have bled in the past are those that are the most likely to bleed again, particularly in the first 2 years after their initial bleed. It is also important to note that a hemorrhage in a cavernoma in the brainstem can be life-threatening, as the brainstem is responsible for regulating critical life processes including breathing and heartbeat.