ABSTRACT

Cerebral cavernous malformation (CCM) also known as cavernoma, cavernous angioma, and cavernous hemangioma is a vascular lesion found primarily in the central nervous system, and less frequently elsewhere in the body. The lesions, which may affect any brain region or the spinal cord, consist of clusters of dilated vascular sinusoids of varying size, filled with blood or thrombus at different stages of organization, giving it the gross appearance of a mulberry (Figs. 9.1,9.2). They grow by a process of vascular cavern proliferation in the setting of repetitive intralesional hemorrhages (1). Lesions typically exhibit hallmarks of previous perilesional hemorrhage, including gliosis and hemosiderin deposit (1). Patients harboring CCMs are predisposed to a lifetime risk of focal neurologic deficits related to hemorrhage or lesion proliferation and epilepsy (2). Hemorrhage from CCM lesion is less likely apoplectic than with higher flow arteriovenous anomalies (3-5); however, at times it can be life threatening (6). The CCM may present as solitary pathology, or often in association with other vascular lesions.