A cavernoma is a malformation of a vessel. The medical term is Haemangioma cavernosum. Basically, a cavernoma is a so-called hemangioma. In principle, the malformation of vessels is possible in all types of tissue. Cavernomas that affect the central nervous system of the human organism are of primary importance for medicine. The central nervous system includes the spinal cord and the brain.
What is a cavernoma?
Cavernomas can be diagnosed using imaging techniques. Magnetic resonance tomography or computed tomography, for example, are possible. See AbbreviationFinder for abbreviations related to Cavernoma.
Vascular malformations are usually benign. With regard to the frequency of occurrence of cavernomas in the population, however, no reliable statements can be made at the present time. The reason for this is that no adequate epidemiological surveys have been carried out to investigate the frequency of cavernomas.
However, the results of autopsies indicate that corresponding malformations of the vessels in the central nervous system can be found in around 0.3 to 1 percent of all cases. However, the cavernomas that can be found usually do not show any symptoms and for this reason in many cases remain completely unnoticed. Frequently, the malformations of the vessels are only discovered and diagnosed by chance, for example in the context of other clinical examinations.
Cavernomas can be detected, among other things, with magnetic resonance imaging and are often found by chance during the procedure. In the majority of cases, a distinction is made between two types of cavernomas, namely cerebral cavernomas and those located in the spinal cord. The latter are also referred to as spinal cavernomas.
Cerebral cavernomas are usually benign arteriovenous malformations of the vessels affecting the brain. Only about 50 percent of all cavernomas are clinically conspicuous. The cerebral cavernomas are characterized by the fact that they appear as special capillary vessels. These vessels are close together and arranged in a cluster.
In addition, there are no visible vessels supplying the capillaries. In some cases, capillary vessels that have expanded in this way are also called cavities in medicine. The malformation of the capillary vessels is surrounded by a special connective tissue. There is no nerve tissue of any kind inside this tissue.
Causes
According to the current state of medical research, the causes of the formation of cavernomas are largely unexplained. From a histological point of view, the abnormal vessels are characterized by thin walls that are fibrosed. Unlike arteriovenous malformations, it is not possible to differentiate between venous and arterial cavernomas.
In the area of cavernomas, there are numerous cases of deposits of substances that are produced when blood is broken down. These substances are also known as haemosiderins. They serve as evidence of bleeding that occurred a long time ago. In the majority of cases, genetic causes for the formation of cavernomas cannot be proven.
However, some patients suffering from vascular malformations show mutations in the corresponding genes. The reasons for the formation of cavernomas in the brain are still not known to this day. It is assumed, however, that the deformities are genetic to a certain extent. They are passed on in an autosomal dominant manner.
Symptoms, Ailments & Signs
Cavernomas are accompanied by a number of typical symptoms and complaints thatdiagnosisfacilitate. For example, there are deformities in the vessels epileptic seizures are possible due to the malformations of the vessels. Sometimes there are also neurological deficits, such as sensory disorders or paralysis.
Cerebral hemorrhage is a dangerous complication. However, there are no reliable data on the probability of bleeding. It is estimated that cerebral hemorrhage occurs in 0.5 to 10 percent of cases. Basically, the individual symptoms of a cavernoma depend primarily on the exact localization.
They are most often discovered due to epileptic seizures. Other possible symptoms are, for example, dysesthesia or paresis. About 80 percent of all cavernomas of the central nervous system are located in a cerebral hemisphere. Only 15 percent arise in the brainstem or cerebellum.
Five percent of cavernomas form in the spinal cord. It should be noted that about half of all cavernomas that occur in the brain show no symptoms. In many cases, these malformations of the vessels are only discovered by accident.
Diagnosis & course of disease
In principle, cavernomas can be diagnosed using various examination methods. As a rule, imaging methods play the most important role. Magnetic resonance tomography or computed tomography, for example, are possible. However, since numerous cavernomas do not cause any symptoms, in many cases they are found by chance during other examinations.
Complications
A cavernoma usually leads to various malformations and malformations in the vessels of the affected person. These malformations can lead to various complaints, which depend on the severity of the manifestation. In most cases, this leads to disorders of the nervous system or the spinal cord, which can cause paralysis and other sensory disorders.
The quality of life is significantly restricted and reduced by the cavernoma. It is not uncommon for epileptic seizures to occur, which can also be associated with pain. If there is no treatment, in the worst case a cerebral hemorrhage occurs, which can be life-threatening for the person concerned. Mental or linguistic problems can also occur, so that the patients suffer from speech disorders or motor impairments.
It is not uncommon for them to depend on the help of other people in everyday life and cannot carry out many activities independently. As a rule, the cavernoma can be removed with the help of a surgical procedure. There are no particular complications. If the cavernomas can be removed easily, the symptoms usually disappear again and there is no reduction in life expectancy.
When should you go to the doctor?
Cavernoma can be fatal without medical care. Therefore, a doctor should be consulted immediately at the first signs, irregularities and disturbances. If there is a feeling of illness, an inner weakness or a loss of performance, there is already cause for concern. A doctor must be consulted in the event of signs of deficiency or various functional disorders of the organism. If epileptic seizures occur, an ambulance is needed. In addition, first-aid measures must be initiated by those present to ensure survival.
Various medical examinations are then required to clarify the cause of the seizure. If circulatory disorders are noticed, this information should be discussed with a doctor. In the event of heart palpitations, a feeling of pressure in the organism, unsteady gait or a collapse, the person concerned needs help. A sudden loss of muscle strength or muscle spasms should be evaluated and treated. If there are disturbances or a loss of consciousness, an emergency service must be alerted.
Intensive medical care is required as quickly as possible because the health condition of the person concerned is life-threatening. If incomprehensible bleeding occurs, more bruises under the skin or bruises are noticed, a doctor’s visit is necessary. In the case of a cavernoma, there are increased complaints in the back area. Therefore, a doctor should be consulted as soon as irregularities are noticed in this region of the body.
Treatment & Therapy
The way cavernomas are treated depends primarily on their localization. If the cavernoma causes bleeding or epileptic seizures, the malformations on the vessels are often removed as part of a surgical procedure.
If cavernomas remain without symptoms and are discovered more or less by chance, surgical intervention is often used as a maintenance measure. In most cases, symptomatic vascular malformations are surgically removed if they are easily accessible. If the cavernomas are in the brain and are asymptomatic, it is often necessary to wait and see.
Outlook & Forecast
The prognosis and outlook of cavernomas varies greatly depending on the exact localization. Cavernomas of the brain, so-called cerebral cavernomas, are of particular interest. Here, too, a distinction is made between superficial and deep vascular malformations. While the superficial cavernomas are located in the cerebral cortex and can occasionally trigger epileptic seizures there, the deep cavernomas are less favorable and sometimes also close to the brainstem. Such cavernomas close to the brainstem can be very dangerous, since they can impair the respiratory center if they enlarge or bleed.
Most cerebral cavernomas are “silent” incidental findings on head imaging, meaning they are asymptomatic. The prognosis is therefore determined by the exact number, anatomical location and risk of hemorrhage of the cavernomas. Deep cavernomas close to the brainstem must be treated surgically in specialized centers, sometimes they are completely inoperable. Thus, the prognosis for superficial cavernomas, which are located on the cerebral cortex, is generally good, since they rarely bleed and therefore rarely cause symptoms.
The outlook is more mixed for deep-seated cavernomas, as these tend to bleed more frequently and tend to occur near anatomically sensitive brain regions. The indication and the possibilities of the operation ultimately determine the prognosis for the patient.
Prevention
There are currently no known measures to prevent cavernomas, as their causes are unclear.
Aftercare
In the case of a cavernoma, those affected usually only have very few aftercare measures available. First and foremost, early detection of the disease is important for this disease, so that further complications and other symptoms cannot occur in the person affected. The earlier a doctor is consulted for a cavernoma, the better the further course of the disease is usually.
Most patients are dependent on surgical interventions, with the number of interventions depending on the symptoms. After such a procedure, the person concerned should definitely rest and take care of his body. Efforts or physical and stressful activities should be avoided in order not to unnecessarily burden the body.
As a rule, no further aftercare measures are then necessary. In the case of a cavernoma in the brain, however, regular check-ups by a doctor are very useful. It is not uncommon for the affected person to have psychological support from their own family, so that depression or other mental disorders do not prevent them. A cavernoma may also limit the life expectancy of the affected person.
You can do that yourself
After the diagnosis of a cavernoma, people can take some measures themselves to support recovery and avoid complications.
Depending on the type of treatment, general measures such as rest, bed rest and a change in lifestyle are recommended. A healthy lifestyle with a balanced diet, physical activity and the avoidance of stress makes sense. However, if there are serious complications such as convulsions or epileptic seizures, an emergency doctor must be called to be summoned. From now on, the person concerned should take measures to avoid accidents and resulting injuries. The responsible doctor can best answer the detailed steps to be taken. This may also refer the patient to a specialized clinic. In addition, the affected vessel should be checked regularly in order to be able to react quickly to any complications.
In some cases, those affected suffer from mental problems. The best way to deal with fears and upsets is with the support of a therapist. If the cavernoma occurs in connection with another disease, further measures must be taken, for example a comprehensive physical examination.
