A cavernoma is also called a cavernous angioma or hemangioma. The names refer to a condition where people have a clustered group of blood cells, usually in the brain or brainstem, which are widened or dilated and which can get larger over time. About one in 200 people have a cavernoma or multiple ones, and sometimes they are completely asymptomatic. However, because the cavernoma can grow, a couple of things may occur with time. They may bleed from time to time, and may start to impact brain function.
Symptoms that a cavernoma is bleeding and creating problems may come on gradually or rapidly. People might have changes to function of limbs, usually on one side of the body. Some people present with serious headaches, and others are likely to have seizures. Under some circumstances people have noted changes in mood or behavior as the cavernoma impacts function.
In most cases, the symptoms of cavernous angioma would be enough to warrant computerized tomography (CT) scans or magnetic resonance imagining (MRI) scans. This is fortunate because both types of scans usually will catch presence of one or more of these lesions. Deciding how to treat is not as simple.
Sometimes the cavernoma is located in an area that is easy to access, and removal of the lesion would not be problematic. Yet this still means performing brain surgery, and if a person recovers from the symptoms associated with bleeding, there may be some reluctance to remove the lesion. At other times symptoms get so severe that removal is absolutely indicated, but if the cavernous hemangioma is located in a hard to reach area of the brain, surgical removal may be very difficult or near impossible. Moreover, in rare instances, people may have multiple lesions instead of just one, and this would make it hard to determine which particular lesion is creating the problem.
One treatment that raises dispute in the medical community is stereotactic radiosurgery. This uses radiation in one treatment at the site of the cavernoma to attempt to destroy it. Most doctors recommend that this be used only if all other options fail, since it is not always effective and may cause severe side effects. Use of radiosurgery is normally considered most if a lesion is in an area of the brain that cannot be reached by typical (scalpel) surgery methods.
Many people do not need surgery for a cavernoma. Even people with numerous ones, may live pretty normal lives. Usually doctors take the approach of watchfulness and might only intervene should problems begin to arise.