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Induction and Micro-CT Imaging of Cerebral Cavernous Malformations in Mouse Model
Published on: September 4, 2017
Incidence, Prevalence, and Clinical Presentation of Cerebral Cavernous Malformations
1Department of Neurology, Mayo Clinic, Rochester, MN, USA. Flemming.kelly@mayo.edu.
Abstract:
The incidence, prevalence, and mode of presentation of cavernous malformations is important to better understand the disease, educate patients and practitioners, aid in treatment decisions, and to design clinical trials. Prior to the advent of MRI, cavernous malformations were often diagnosed only when a catastrophic event occurred and/or the lesion was removed. With the more frequent diagnostic use of MRI, it has become clear that cavernous malformations are more prevalent than previously thought and many are identified incidentally. The remainder may present to clinical attention with intracerebral hemorrhage, seizure without hemorrhage, or focal neurologic deficit without overt hemorrhage. The precise reason why some cavernous malformations become symptomatic and others remain asymptomatic is not clear. However, evolving data suggests that brainstem location, estrogen use in women, and low vitamin D may play a role in hemorrhagic presentation.
Insights
Cavernous malformations are more common than previously thought, often found incidentally with MRI. Some may present with hemorrhage, seizure, or neurological deficits, with factors like location and vitamin D potentially influencing symptoms.
Area of Science:
- Neurology
- Neuroimaging
- Vascular Neurology
Background:
- Cavernous malformations (CMs) were historically diagnosed late, often after severe events.
- The widespread use of Magnetic Resonance Imaging (MRI) has increased incidental detection of CMs.
- Understanding CM presentation is crucial for patient care and research.
Purpose of the Study:
- To review the incidence, prevalence, and presentation of cavernous malformations.
- To highlight the impact of MRI on CM diagnosis.
- To discuss factors potentially influencing symptomatic presentation.
Main Methods:
- Literature review and synthesis of existing data on cavernous malformations.
- Analysis of diagnostic trends before and after the widespread adoption of MRI.
- Examination of clinical presentations and potential contributing factors.
Main Results:
- Cavernous malformations are more prevalent than previously recognized, with many identified incidentally via MRI.
- Symptomatic presentations include intracerebral hemorrhage, seizures, and focal neurological deficits.
- Brainstem location, estrogen use, and low vitamin D levels are suggested factors in hemorrhagic presentation.
Conclusions:
- Increased MRI use has shifted CM diagnosis towards incidental findings.
- While many CMs remain asymptomatic, specific factors may increase the risk of symptomatic events.
- Further research is needed to clarify the precise mechanisms driving CM symptomatology and hemorrhage risk.
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