Management of cranial and spinal cavernous angiomas (honored guest lecture)

The management of patients with cavernous angioma continues to evolve. Our current recommendations for management are as follows. 1. Patients who are asymptomatic are observed. 2. Patients with acute severe or progressive neurological deficits are operated upon. 3. Patients presenting with a seizure are usually operated upon but some are observed, depending on the factors discussed. 4. Patients with a single hemorrhage in the cerebrum, cerebellum, or spinal cord are usually operated upon. When the hemorrhage is in the brainstem, thalamus, or basal ganglia, they are observed. 5. Patients with a recurrent hemorrhage are usually operated upon but there are exceptions when the lesion is in a deep area with high surgical risk.