Cavernous angioma natural history, complications and prognosis
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Cavernous angioma Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Natural History
Once patients become symptomatic, 40-50% present with seizures, 20% present with focal neurologic deficits, and 10-25% present with intracerebral parenchymal hemorrhage.
Complications
The risk of hemorrhage is not well established, but it is estimated to be 0.2-2% per lesion per year. This risk is increased in patients with established prior hemorrhage. The clinical consequences of hemorrhage vary such that location becomes important. Small hemorrhages in critical locations can have more severe effects, and thus, they are more likely to produce symptoms (eg, brainstem involvement). Progressive neurologic deficits are more often associated with cavernous malformations in the infratentorial space and with lesions that demonstrate slow enlargement because of rebleeding episodes.
Prognosis
The lesions do not usually produce life-threatening hemorrhages because most hemorrhages associated with the lesions are small and of low pressure. Cavernous malformations can occur at any age, but they are most likely to become clinically apparent in patients aged 20-40 years.