Department of  Neurosurgery
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Cavernous Malformation

A cavernous malformation is an abnormal cluster of small blood vessels that resembles a raspberry or honeycomb. A person can have one or more cavernous malformations in their brain. Cavernous malformations occur in 0.5%-1% of the population and appear most often among people of Hispanic descent. Some cavernous malformations run in families, but most are sporadic (do not run in families).

Cavernous Malformation

Washington University cerebrovascular surgeons work as part of a multidisciplinary team to offer treatment for cavernous malformations at the Barnes-Jewish Hospital Stroke and Cerebrovascular Center.

The Center is among the most experienced in managing brain vascular malformations and receives physician referrals from across the country. In addition to cerebrovascular surgeons, other physician members of the treatment team include neurologists who specialize in interventional radiology as well as critical care and neuro-rehabilitation neurologists.


Symptoms

Many people who have a cavernous malformation experience no symptoms at all and are diagnosed simply by chance. Others seek medical attention when symptoms appear. Cavernous malformations can cause two main types of symptoms:

Seizures: As with arteriovenous malformations, cavernous malformations can cause seizures—but not necessarily the kind in which the body shakes rapidly and uncontrollably. Some seizures are mild, lasting from 30 seconds to 2 minutes and causing no lasting harm.

Brain hemorrhage: Cavernous malformations can rupture and cause brain bleeding—also referred to as a bleeding, or hemorrhagic stroke. Symptoms that suggest brain hemorrhage are sudden onset of severe headache, nausea, vomiting, weakness or numbness on one side of the body, difficulties in speaking or understanding speech, loss of vision, double vision and balance difficulties. People experiencing any of these symptoms need to seek medical help immediately. Brain hemorrhage from a cavernous malformation is a serious form of stroke, but one that is typically nonfatal. Many patients make full recoveries after hemorrhage from a cavernous malformation. 

Treatment

Cavernous malformations are treated on a case-by-case basis. The treatment selected depends on the location of the cavernous malformation, the severity and nature of symptoms, the patient’s age and health status, and the risk involved in treatment. Treatment options include observation and surgery.

Observation

Often an appropriate choice for patients who are symptom-free, observation may also be appropriate for certain patients with symptomatic cavernous malformations who are older, have multiple medical problems or have a complex or difficult-to-reach cavernous malformation where treatment carries a high risk.

Surgery

Performed as an inpatient procedure, removal of the cavernous malformation from the brain is performed through open surgery. If successful, it provides immediate protection against brain bleeding and may also reduce or eliminate the risk of seizure. Surgery is a good option for many cavernous malformation patients; however, some patients have a complex or difficult-to-reach cavernous malformation that limits this treatment option.

Cavernous Malformation 

Conferences

The cerebrovascular conference is held weekly. All cerebrovascular cases are reviewed by neurosurgeons and interventional neuro-radiologists to determine an optimal, individualized treatment plan.

Physicians wishing to submit cases for review should contact the Cerebrovasculr Nurse Coordinator at 314-747-8882.

Faculty

Neurosurgery Providers - Cerebrovascular Surgeons

Interventional Neuroradiology Providers

  • DeWitte T. Cross, MD
  • Colin P. Derdeyn, MD
  • Christopher J. Moran, MD

Radiation Oncologists

  • Joseph Simpson, MD, PhD, FACR
  • David Mansur, MD
  • Imran Zoberi, MD

Critical Care Neurology Providers

  • Rajat Dhar, MD
  • Michael Diringer, MD
  • Salah G. Keyrouz, MD
  • Terrance Kummer, MD, PhD

Neuro-Rehabilitation Providers

  • Alex Carter, MD
  • Maurizio Corbetta, MD
  • Robert Fucetola, PhD
  • Thy Huskey, MD