Cavenous Malformation Flashcards

1
Q

AKA cavernous malformation

A

AKA: cavernous hemangioma, cavernoma, cavernous angioma, angioma, hemangioma,

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2
Q

DX

A

MRI 2 + SWI / GRE popcorn 🍿 apreance ➡️➡️ Pathonemonic
MRI c r/o DVA , cpillary telangictisa
Angio CM usually occult 🚫 unless to R/ o AVM
Spine In the absence of spine symptoms, routine imaging of the spine is not indicated in patients with cerebral CMs.31

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3
Q

Flow cavernoma

A

Low
Without brain 🧠 pranchyam🔛 HHT

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4
Q

Pathology

A

Defect endothelia junction , absence of muscular layer

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5
Q

📍 location

A

80 % supratentorial ➡️followed by. Brain stem ( pons)🆙▶️ multiple

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6
Q

RF cavernoam

A

Radiation

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7
Q

Genetic carvnouma

A
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8
Q

Sx k

A

Seizure
Hemorrhage
Ficalmdefictn

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9
Q

Presentation

A

Seizure > hemorrhage

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10
Q

Factor ⏏️ bleed 🩸

A

Initially present with hemorrhage
Brainstem CM
Extralesional
Age < 30
Deep location
Size > 1 cm
Female
Pregnancy 🤰🏼
Prior bleed

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11
Q

Annular risk of recent bleeding

A

Sparodic 2,5 y vs familial 4-6 %
Spine 2%

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12
Q

Zabramski classification of cavernous malformation

A

MCC type 2

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13
Q

Sscreening

A

1 st degree relative + one family memebrer with CM ➡️ indicate MRI screening + genetic counseling

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14
Q

TX surgical indications

A

Asymptomatic ➡️solitary , non eloquent ➡️aim ⬇️ bleed, psychological, follow up , lifestyle, resume anticoagulant
Symptomatic ;
< 6 was if w/ seizure related to the lesion and refractory
M&M = 1-2 y after 1 st bleeding
⭐️ 2nd 🥈 symptomatic bleeding brainstem

Deep with symptom as or previous hemorrhage M&M = 5-10 yes after 1st 🩸
Weak indication➡️ sin
Emdisbaling bleeding from brainsteam

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15
Q

Radiotsurgery CM

A

Deep and eloquent, wi hemorrhage

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16
Q

Follow up Cm

A

Asymptomatic, incidentally 2-3 y to r/o sub clinical bleedign
Post op 3 month

17
Q

Poor outcome

A

Brainsteam CM b.EVD and approach through floor of the 4th
Deep BG , thalamus

18
Q

Cavernoma variants .

A

Hemangioma calcificans variant s variant of cavernoma occurs more in the temporal lobe