Which are the symptoms?
They are usually diagnosed in people aged 20-40.
They are fairly common, occurring in 0.4-0.5% of autopsies (1 in 200 people) and can be multiple in 6-18% of cases.
Sometimes they occur in more than one member of the same family, and familial cases with multiple lesions of the brain, retina, liver, kidney, heart and skin are possible in connection with Rendu-Osler-Weber syndrome (hereditary haemorrhagic telangiectasia).
The most common symptom is an epileptic seizure.
In 18-20% of cases, the disease is detected by examinations carried out for other reasons.
At the time of diagnosis, often there are already signs of previous small haemorrhages. Cavernous angiomas can also cause neural haemorrhages, often of limited extent, the clinical consequences of which vary according to location.
Angiomas can increase in size over time.
How is it diagnosed?
The examination of choice is a magnetic resonance imaging scan. Computed tomography (CT) can be used to suspect the presence of a malformation, but does not allow a definitive diagnosis.
Cerebral angiography, on the other hand, is negative unlike other vascular malformations.
How is it treated?
These are low-risk lesions for bleeding, and it is difficult, should this occur, for the bleeding to be so massive as to cause severe neurological deficits.
Treatment consists of surgical removal and is indicated for:
- lesions that have bled, because after a first hemorrhage there is a greater likelihood of a second, which is usually more severe than the first;
- patients who have intractable seizures: removal of the lesion and surrounding fibrous area is often effective in treating these seizures;
- multiple lesions (removal of only the symptomatic lesion, while the others are not treated).