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Induction and Micro-CT Imaging of Cerebral Cavernous Malformations in Mouse Model
Published on: September 4, 2017
Cavernous malformations
1Department of Neurosurgery, Haukeland University Hospital, Bergen, Norway.
Abstract:
Cavernous malformations are relatively common intracerebral malformations of which we only became properly aware after the introduction of MRI. They may be sporadic or familial. Familial CMs may be multiple and new lesions appear over time requiring intermittent MR control. Many sporadic CMs have no symptoms. The commonest location is in the supratentorial cerebral parenchyma presenting with epilepsy. The best treatment is microsurgery. A small proportion are in the brainstem and may rebleed and even be lethal. Treatment includes microsurgery and radiosurgery. Microsurgery cures the patient but has substantial problems with complications, deterioration and partial removal. Radiosurgery has taken time to demonstrate that it can over 2 years substantially reduce the risk of rebleeds without the risks of microsurgery. Both methods have a part to play in the treatment.
Insights
Cavernous malformations (CMs) are common brain lesions. While microsurgery offers a cure, radiosurgery provides a safer alternative for reducing rebleeding risks over time.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Cavernous malformations (CMs) are prevalent intracerebral vascular anomalies, increasingly detected with MRI.
- CMs can be sporadic or familial, with familial types potentially exhibiting multiple lesions requiring ongoing monitoring.
- Many sporadic CMs are asymptomatic, but supratentorial lesions commonly present with epilepsy.
Purpose of the Study:
- To review the characteristics and treatment options for cavernous malformations.
- To compare the efficacy and risks of microsurgery versus radiosurgery for CM treatment.
Main Methods:
- Review of literature on cavernous malformations.
- Analysis of treatment outcomes for microsurgery and radiosurgery.
Main Results:
- Microsurgery is curative but associated with significant risks of complications, patient deterioration, and incomplete removal.
- Radiosurgery, demonstrated over two years, effectively reduces rebleeding risk with lower complication rates compared to microsurgery.
- Brainstem CMs pose a higher risk, including potential lethality, necessitating careful treatment considerations.
Conclusions:
- Both microsurgery and radiosurgery have distinct roles in managing cavernous malformations.
- Radiosurgery offers a viable alternative to microsurgery, particularly for reducing rebleeding risks without the associated surgical complications.
