Cavenous Malformation Flashcards
AKA cavernous malformation
AKA: cavernous hemangioma, cavernoma, cavernous angioma, angioma, hemangioma,
DX
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
Flow cavernoma
Low
Without brain 🧠 pranchyam🔛 HHT
Pathology
Defect endothelia junction , absence of muscular layer
📍 location
80 % supratentorial ➡️followed by. Brain stem ( pons)🆙▶️ multiple
RF cavernoam
Radiation
Genetic carvnouma
Sx k
Seizure
Hemorrhage
Ficalmdefictn
Presentation
Seizure > hemorrhage
Factor ⏏️ bleed 🩸
Initially present with hemorrhage
Brainstem CM
Extralesional
Age < 30
Deep location
Size > 1 cm
Female
Pregnancy 🤰🏼
Prior bleed
Annular risk of recent bleeding
Sparodic 2,5 y vs familial 4-6 %
Spine 2%
Zabramski classification of cavernous malformation
MCC type 2
Sscreening
1 st degree relative + one family memebrer with CM ➡️ indicate MRI screening + genetic counseling
TX surgical indications
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
Radiotsurgery CM
Deep and eloquent, wi hemorrhage