Cavernous Malformations of the Brain (Brain Cavernomas) Characteristics and Treatment Options

Cavernous malformations of the brain are benign tumors that develop from the blood vessels in the brain. Despite the fact that they are benign, they can cause many functional problems connected to brain function. The treatment of cavernomas sometimes requires nothing more than monitoring, but in some cases, it can require highly complex and delicate surgical intervention.

Since cavernomas develop from blood vessels in the brain itself, they can appear in a variety of locations within the brain, including the brain stem, which is one of the most sensitive areas in the body. In the past, brain cavernomas were rarely diagnosed; however, significant advances in imaging techniques have ensured rapid and precise diagnosis of these tumors, which can prove to be life saving.

At the Herzliya Medical Center’s Neurosurgical Center for Excellence, there are highly experienced neurosurgical specialists proficient in the most advanced microsurgical techniques, including operations to remove brain cavernomas.

Features of Brain Cavernomas

As mentioned previously, brain cavernomas develop from blood vessels in the brain. Cavernomas are essentially vascular complexes composed of veins, or a non-malignant “mass” of blood vessels. The blood pressure within the cavernoma’s vessels is characteristically very low, thereby preventing their removal via catheterization (a possible treatment option in other medical conditions that involve the brain).

In many cases, whether because of their miniscule size or because they have developed in a region of the brain that is less sensitive or critical, cavernomas cause no symptoms at all. Sometimes, brain cavernomas are discovered incidentally during an imaging test performed for some other reason.

The development of a cavernoma can, however, be dangerous, particularly if it develops in a highly sensitive region such as the brain stem. In such an instance, even a small bleed can be life threatening.

As a rule, cavernomas cause three main symptoms:

• Headaches resulting from the fact that a cavernoma is pressing on adjacent tissues
• Epileptic seizures
• Intracerebral bleeding.

The appearance of one or more of these symptoms requires imaging evaluation, during which your doctor will attempt to identify the location of the tumor, if one exists. The most effective diagnostic test for discovering a brain cavernoma is an MRI, which you will undergo at the advanced Imaging Institute at the Herzliya Medical Center.

How are brain cavernomas treated?

The treatment approach for brain cavernomas is decided upon based on the location of the tumor and the symptoms from which you are suffering. If the tumor is not causing any symptoms, and if the tumor appears in a region that is not particularly sensitive, regular monitoring may be the best treatment option. This will allow your doctor to make sure that the cavernoma is not growing and does not begin causing any symptoms.

If you are experiencing symptoms, or if the cavernoma is located in an area of the brain that is considered to be high risk, your doctor will usually choose to remove the tumor surgically.

Surgery for the removal of a brain cavernoma is considered to be rather complex, especially if the tumor has developed in a sensitive or hard-to-access region of the brain. Such an operation typically requires the use of special microsurgical instruments and advanced technologies that will allow for monitoring of brain function during the operation, such as a functional MRI (fMRI), which allows for evaluation of brain function at any given time.
This monitoring is very important, especially in the event that the tumor has developed adjacent to areas such as the brain’s speech area, significantly endangering them. In such instances, some or all of the operation will be performed under local anesthesia only, in order to ensure in real time that the operation is being performed successfully, without damaging the brain’s functional systems.

Success of the operation depends on the surgeon’s skill and on the quality of the working environment in which the operation is performed. At the Neurosurgical Center for Excellence at the Herzliya Medical Center, the best experts in the field of neurosurgery and microsurgery use the most sophisticated and advanced instrumentation in the field. Together, all of these factors ensure the greatest chance of success of the operation to remove of the cavernoma.

Are you suffering from symptoms that are characteristic of a brain cavernoma?

Contact us today at the Neurosurgical Center for Excellence at the Herzliya Medical Center to ensure the most precise and professional operation under the best of conditions.