Cavernous angiomas are slow-flow vascular lesions consisting of sinusoidal vascular channels lined by a single layer of endothelium, separated by collagenous stroma, and without any normal intervening neural tissue. Grossly, they are well-circumscribed reddish-purple lesions, often likened to a mulberry or cluster of mulberries. There is a characteristic gliotic reaction in the surrounding parenchyma, which may form a pseudocapsule. Within the lesion, there is often evidence of hyalinization, thrombosis in various stages of organization, calcification, cholesterol crystals, and cysts.18 The immediate surrounding parenchyma may contain small, low-flow feeding arteries and draining veins. In a review of 57 reported cases of spinal cavernomas, Canavero et al.19 found that 69% of the patients were women, with a mean age of 36.4 years at diagnosis. They estimated a 1.6%/person/ year risk of bleeding, with a higher risk in cervical lesions. Magnetic resonance imaging (MRI) was found to be diagnostic in all cases, while angiography was negative in 100%. This latter finding is not strange, considering that cavernomas are one of the classically "angiographi-cally occult" vascular malformations.
Treatment is by conservative approach or surgical resection. There is no role for an endovascular approach.
Was this article helpful?
This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.