Clinical Management of Cavernous Malformations

Curr Cardiol Rep. 2017 Oct 18;19(12):122. doi: 10.1007/s11886-017-0931-1.

Abstract

Purpose of review: This study aims to review the current epidemiology and clinical management of patients with cavernous malformations (CM).

Recent findings: Hemorrhage is the most feared complication and leads to morbidity in patients with CM. Multiple studies including three meta-analyses have provided useful estimates of hemorrhage risk, but have failed to identify a modifiable risk factor for prevention of cavernous malformation related hemorrhage. In treating the CM itself, surgical risk is weighed against the natural history. However, accumulating knowledge regarding the roles of CCM 1, 2, and 3 genes has led to the discovery of potential therapeutic targets. The risk of future hemorrhage in patients with CM is highest in those who have had previously clinical hemorrhages. Estimated risks are helpful in counseling patients and comparing to the risk of surgery. Future clinical trials of candidate medications are likely to target those patients with prior clinical hemorrhage in whom the surgical risk is deemed high.

Keywords: Cavernous angioma; Cavernous malformation; Epidemiology; Management; Treatment.

Publication types

  • Review

MeSH terms

  • Anticonvulsants / therapeutic use*
  • Apoptosis Regulatory Proteins / genetics
  • Carrier Proteins / genetics
  • Cerebral Hemorrhage / etiology
  • Cerebral Hemorrhage / prevention & control*
  • Disease Management
  • Hemangioma, Cavernous, Central Nervous System / complications
  • Hemangioma, Cavernous, Central Nervous System / diagnostic imaging
  • Hemangioma, Cavernous, Central Nervous System / genetics
  • Hemangioma, Cavernous, Central Nervous System / therapy*
  • Humans
  • KRIT1 Protein / genetics
  • Laser Therapy
  • Magnetic Resonance Imaging
  • Membrane Proteins / genetics
  • Molecular Targeted Therapy
  • Neurosurgical Procedures*
  • Proto-Oncogene Proteins / genetics
  • Radiosurgery*
  • Seizures / drug therapy
  • Seizures / etiology
  • Seizures / prevention & control*
  • Stereotaxic Techniques
  • Tomography, X-Ray Computed

Substances

  • Anticonvulsants
  • Apoptosis Regulatory Proteins
  • CCM2 protein, human
  • Carrier Proteins
  • KRIT1 Protein
  • KRIT1 protein, human
  • Membrane Proteins
  • PDCD10 protein, human
  • Proto-Oncogene Proteins