CEREBRAL CAVERNOUS MALFORMATIONS

Course overview

A CEREBRAL CAVERNOUS MALFORMATION (CCM) IS AN ABNORMALLY LARGE COLLECTION OF "LOW FLOW" VASCULAR CHANNELS WITHOUT BRAIN PARENCHYMA INTERVENING BETWEEN THE SINUSOIDAL VESSELS. CLINICALLY, CEREBRAL CAVERNOUS MALFORMATIONS HAVE HIGHLY VARIABLE PRESENTATIONS. ADDING TO THE CONFUSION, THEY ARE ALSO REFERRED TO AS CAVERNOMAS, CAVERNOUS ANGIOMAS, AND CAVERNOUS HEMANGIOMAS, THOUGH CCM IS THE PREFERRED NOMENCLATURE. CCMS RANGE IN DIAMETER FROM UNDER A MILLIMETER TO SEVERAL CENTIMETERS AND MAY OCCUR ANYWHERE IN THE CENTRAL NERVOUS SYSTEM WITH UP TO 20 PERCENT LOCATED IN THE BRAINSTEM. CCM MAY BE DIAGNOSED IN BOTH YOUNG CHILDREN AND ADULTS AND MAY DEVELOP DE NOVO OR EVEN REGRESS SPONTANEOUSLY DURING A PATIENT’S LIFETIME. THOROUGH KNOWLEDGE OF THE NATURAL HISTORY OF THIS ENTITY IS OF PARAMOUNT IMPORTANCE TO AVOID UNNECESSARY AND POTENTIALLY MORBID INTERVENTIONS. GIVEN THE HETEROGENEITY OF THIS CONDITION, THE ONTOGENESIS, DIAGNOSIS, MANAGEMENT STRATEGIES FOR CCM ARE SUBJECTS OF ONGOING DEBATE AND TREATMENT PARADIGMS CONTINUE TO EVOLVE. THIS ACTIVITY REVIEWS THE PATHOGENESIS, DIAGNOSIS, EVALUATION, AND TREATMENT OF CEREBRAL CAVERNOUS MALFORMATIONS AND EMPHASIZES THE ROLE OF THE INTERPROFESSIONAL TEAM IN IMPROVING CARE FOR PATIENTS WITH THIS CONDITION.