A cavernoma is a small cluster of thin-walled, slow-flowing blood vessels in the brain or spinal cord that looks rather like a raspberry. It is not a tumour and not cancer.
Many are found by chance and never cause trouble. Problems arise when a cavernoma oozes or bleeds, which tends to produce small, contained bleeds rather than the catastrophic haemorrhage seen with aneurysms.
Symptoms
- No symptoms in a large share of people
- Seizures, the most common presenting problem
- Headache
- Gradual or stepwise weakness, numbness, double vision or unsteadiness, depending on location
- Sudden neurological symptoms from a bleed, especially with brainstem lesions
Causes and risk factors
Most cavernomas are single and sporadic, often lying beside a harmless developmental venous anomaly. About one in five patients has the familial form with multiple lesions, caused by a variant in the CCM1, CCM2 or CCM3 gene and inherited in a dominant pattern. Radiotherapy to the brain in childhood can lead to cavernomas years later. The annual bleeding risk is low for incidental lesions and clearly higher for those that have already bled or sit in the brainstem.
How it is diagnosed
- MRI with susceptibility-weighted sequences: The key test. It shows the typical popcorn appearance with a dark rim of old blood and picks up tiny additional lesions.
- CT scan: Used in an emergency to show fresh bleeding, but misses many cavernomas.
- EEG: Helps link a lesion to seizures.
- Genetic testing: Offered when there are multiple lesions or affected relatives. Catheter angiography is usually normal and is not needed.
Treatment options
- Observation: The usual approach for incidental or deep lesions, with repeat MRI if symptoms change.
- Anti-seizure medication: Controls epilepsy in most patients.
- Microsurgical removal: Considered for accessible lesions causing a symptomatic bleed or drug-resistant seizures. Removal is curative for that lesion.
- Brainstem and deep lesions: Surgery only after repeated bleeds and when the lesion reaches a safe surface, in experienced hands.
- Radiosurgery: Its benefit is debated. It is an option some centres offer for inoperable lesions with repeated bleeds.
When it is urgent
Sudden severe headache, a first seizure, new double vision, weakness, numbness or trouble speaking need emergency imaging locally. A prolonged seizure lasting more than five minutes needs an ambulance.
Travelling to Türkiye for treatment
Because decisions are rarely urgent, this condition suits a remote second opinion on your MRI followed, if surgery is advised, by a planned trip of about two weeks. Be wary of any recommendation to operate on an incidental, silent cavernoma. Seizure management and repeat scans belong with your local neurologist. Driving rules after seizures or brain surgery differ by country, so check yours.
Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.
Frequently Asked Questions
Can I take aspirin or blood thinners?
Current evidence suggests they do not increase bleeding from cavernomas, but the decision should be made with your doctors.
Is pregnancy safe?
Studies have not shown a clearly higher bleed risk in pregnancy. Plan delivery with your obstetric and neurology teams.
Should my family be scanned?
Only if you have multiple lesions or a known family history, after genetic counselling.
Do cavernomas grow?
Some change in size over time because of small internal bleeds, and new ones can appear in the familial form.