Cerebral cavernous malformation (CCM) is a malformation of blood vessels that run in the brain or spinal cord. This condition does not require surgery in all cases, but many complaints may require surgery, for example when the deformity is located in the brain stem. Possible complaints include double vision, noise in the ear, headache, concentration problems and tingling in the arms and legs.
Cerebral cavernous malformation
- What is a cerebral cavernous malformation?
- Associated conditions
- Symptoms of cavernous malformation
- Therapy
What is a cerebral cavernous malformation?
A cerebral cavernous malformation (CCM) is a malformation of blood vessels or veins in the brain or spinal cord. When an attempt is made to obtain an image by means of angiography with contrast fluid, this is very difficult to display. This is why the condition owes its nickname, occult or cryptic vascular malformation. Ultimately, it is often an MRI scan that must provide a definitive answer. Not infrequently, a malformation is discovered by chance when a patient has to undergo a scan for another reason.
CCM exists in different variants. It can occur as a single or multiple deformity. In addition, there is also familial CCM. This is a congenital variant of the condition, but is very rare. Little is known about its cause. Scientists have made a connection with the genes Ccm1, Ccm2, and Ccm3. A malformation can also occur in other places in the body such as the liver, kidneys or eye.
CCM occurs in approximately 0.5% of the population, but approximately half of them never develop complaints. The condition occurs equally often in men and women and no specific population group appears to be affected more often. The exception to this is the familiar form. In America, it has been found that this form of CCM is relatively more common among Latinos.
Leandro Castan
In November 2014, the football world was shocked by the news that AS Roma player Leandro Castan had to undergo brain surgery due to a vascular malformation. After a match for his club, he suffered from reduced vision and dizziness. Research in the hospital showed that it is a cavernous hemangioma that should be easy to treat with surgery. This means he will be out of action for months, but he must be able to make a full recovery.
Associated conditions
In a Galeno artery aneurysm, a malformation occurs in the center of the brain and results in blood flowing directly from the arteries to the veins. This is a serious birth defect that leads to heart failure. Children born with this abnormality have only limited intellectual capacity.
The condition is sometimes incorrectly referred to as a cavernoma . This is unjustified, as a cavernoma is a type of tumor.
Symptoms of cavernous malformation
The main symptoms of a cavernous malformation are seizures and neurological deficits. These symptoms usually occur in people between the ages of 20 and 40. Other symptoms that may occur include:
- Double vision and blurred vision
- Problems with language and speech
- Amnesia
- Concentration problems
- Mild to severe headache
- Weakness or tingling in the arms and legs
- Balance disorders
- Dizziness
- Murmur in the ear (souflle)
Therapy
It is not always necessary or possible to treat a cavernous malformation. This depends on a number of factors such as the severity of the complaints, the age of the patient, the precise location of the deformity, and the general physical and neurological condition of the patient. In the majority of cases, people with no or few complaints will choose to monitor the condition carefully and not intervene. If the complaints are more serious and there is a possibility, surgical intervention will be chosen. Treatment with medications or something like neurovascular intervention has no proven benefit in this condition.
American research has shown that the condition may in the future be treated with a drug that is also used to combat high cholesterol levels. Its effectiveness has been demonstrated in tests with rats. However, more research results are needed before this method can also be tested in humans.
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