Principles for managing cavernous malformations in eloquent locations

Abstract

Introduction Cerebral cavernous malformations (cavernomas) are one of the four types of cerebrovascular malformations. The other three are arteriovenous malformations, capillary telangiectases, and venous malformations [1]. A sporadic and a hereditary form of cavernous malformations have been described [2]. These lesions are well-circumscribed, consisting of closely packed and enlarged capillary-like vessels. They do not contain intervening parenchyma and, histologically, the vascular channels (which resemble dilated capillaries) are lined by a single layer of vascular endothelium surrounded by a layer of dense fibrous tissue [3, 4]. Cavernous malformations account for 5% to 10% of vascular malformations in the central nervous system. Eighty percent are located supratentorially, with a mostly superficial preference, and these histopathologically benign lesions occur in 0.1% to 0.9% of the population [5–8]. © Cambridge University Press 2011.