Treatment of Cavernoma

The treatment of cavernoma in Israel is carried out by the specialists of the Neurosurgical Department of the private clinic of Herzliya Medical Center. Along with modern surgical methods, innovative non-invasive radiosurgery technologies are widely used in the hospital in order to achieve excellent results in previously considered incurable cases of vascular pathology of the central nervous system.

What is cavernous malformation?

Cavernoma or cavernous malformation is the malformation of the blood vessels with the formation of thin-walled cavities, separated by multiple partitions. These cavities are filled with blood and its decay products. The size of the cavity varies from a few millimeters to several centimeters, averaging 2-3 centimeters. There are both single and multiple malformations. The main reason for the development of a cavity is genetic predisposition; however, there are also external risk factors, for example, ionizing radiation. The most frequent complication of the cavity is the bleeding caused by the rupture of thin partitions and vascular walls.

Brain Cavernoma

Most cavernous malformations of the brain are located in the region of the hemispheres, mainly in the subcortical zone, less often in the deep sections and in the cerebellum. A long asymptomatic course of the disease is often observed. Cavernoma may turn out to be an accidental “finding” during an instrumental investigation, carried out according to other indications. The presence and severity of clinical symptoms are influenced by a number of factors, the main of which include:

• The size of the cavernoma, as well as the presence of multiple foci of cavernous malformations
• Closeness to vital brain centers
• The presence of bleeding from the area of malformation and its intensity

Focal and cerebral symptoms (headache, nausea, impaired vision and speech, loss of balance, difficulty in swallowing, numbness of a part of the body or weakness, convulsions) are not typical, and require emergency differential diagnosis with cerebral circulation disorders or volumetric processes (brain tumors).

The location of the cavernous malformation in the brainstem is dangerous since it damages vital autonomous centers, as well as a multitude of pathways concentrated in a relatively small anatomical region. Even minor hematomas caused by bleeding from the cavernoma can be accompanied by severe focal and cerebral symptoms. Characteristic neurological signs of this localization are dysfunctions of the cranial nerves.

Spinal Cavernoma

Cavernous malformations of the spinal cord are much less common; however, in the overwhelming majority of cases, they develop with pronounced symptoms of segmental and conductive disorders. Recurrent hemorrhages from the cavern region lead to progressive impairment of sensitivity, motor function, and autonomic disorders. Dysfunction of the pelvic organs is often observed. The lack of timely diagnosis and qualified treatment of spinal cord cavernoma can lead to irreversible changes and severe disability.

Diagnosis of cavernous malformation

Even though the vascular pathology is considered, angiographic methods are ineffective for the diagnosing cavernoma, since the blood flow has a low speed in the area of malformation, due to the peculiarities of its structure. Small cavernomas are slowly filled with a contrasting substance and are often unnoticed on CT and angiography of the brain vessels. The main method for the diagnosis of the disease is magnetic resonance imaging (MRI), which allows us to determine the smallest structural changes, including blood vessels, as well as to diagnose the hematomas surrounding the malformations.

Treatment of cavernous malformations in Herzliya Medical Center

Based on anamnesis (medical history), clinical presentation and MRI results, the neurosurgeons of Herzliya Medical Center determine the most effective and safe method of treatment. It is possible to carry out the radical therapy of cavernous malformation in two ways:

• Surgical removal. The possibility of this method depends on the location of the cavernoma. Unfortunately, the removal of deep-seated malformations, as well as the processes that adjacent to vital structures and pathways, is a danger of possible complications and is not always technically possible.

The vast clinical experience of neurosurgeons and the most modern equipment of the leading private clinics in Israel guarantee the successful treatment of brain and spinal cord cavities.