Management of Cerebral Cavernous Malformations: From Diagnosis to Treatment

Figure 1

Flow-chart of the work-up and management of patients with cavernous malformations. Once a cavernomas is diagnosed via an MRI of the brain, deciding the course of treatment depends on the clinical presentation of the patient. Purely incidental cavernomas are managed conservatively and followed by yearly MRI scans. Cavernomas are treated by microsurgical resection or stereotactic radiosurgery if the patient is experiencing severe symptoms, such as intractable seizures, progressive neurological deterioration, one severe hemorrhage in a noneloquent region of the brain, or at least two severe hemorrhages in eloquent brain. Selecting between resection and radiosurgery depends on the location of the lesion and the severity of the presentation as explained in this paper.