Cavernous Malformations of the Brain & Spinal Cord

Though some patients have no symptoms, approximately 60% are diagnosed between the ages of 20 and 40 after experiencing symptoms such as:

• Headache
• Brain hemorrhage
• Problems with vision, balance, memory or attention
• Seizures
• Trouble speaking or swallowing
• Weakness or numbness in the face, arms or legs

Approximately 20% of cases can be traced to genetic mutations. However, most occur as a single formation with no apparent cause or familial link. After we discuss your personal and family medical history, we will order CT imaging or a specialized MRI called gradient echo sequencing to detect dilated blood vessels. 

Dilated blood vessels have multiple pockets (caverns), through which blood slowly passes. They form in the brain’s cortex, the thin “gray matter” covering the brain, and tend to leak blood. Cavernous malformations often look like small blackberries, but can change in size and number over time.

Cavernous malformations that are not bleeding or causing symptoms may not require immediate treatment. Houston Methodist neurologists will monitor your condition to watch for changes in size, shape or volume. 

If you are experiencing symptoms or your condition changes, we will recommend an innovative, precise treatment to restore your quality of life and reduce the risk of future complications. Treatment options may include:

• Craniotomy – The neurosurgeon removes a small portion of the skull to access the brain and remove the malformation. Then, we repair the skull. 
• Laminectomy – The neurosurgeon removes the back part of the vertebra covering the spinal canal (the lamina) to relieve pressure on the spinal cord or nerves and reduce or eliminate symptoms.

After surgery, patients who do not experience neurological deficits can often return to baseline through physical therapy. Most patients resume normal activities within a couple weeks. Patients with neurological deficits may need a longer, more intensive rehabilitation period.