Description

Cerebral cavernous malformations (Ccms) are clusters of tight, irregular, small blood vessels with thin walls. They may be present in the brain or the spinal cord. The vessels that contain the slow movement of the blood that normally coagulated. The ccm look like small berries. In some people, the Ccm can cause blood to leak into the brain or the spinal cord.

The mcp vary in size. Are often less than half of an inch (1 centimeter). The majority of the Mcp are sporadic. This means that the MCP is produced as a single cavernous malformation, and there is a family history. But about 20% of the Mcp affect people in the same family. These are known as a family member of the Ccm. Family Mcp are related to a change in the gene passed down through the families. People with family members of the Ccm tend to have multiple cavernous malformations.

The CCM is one of several types of vascular malformations of the brain containing irregular blood vessels. Other types of vascular malformations include:

  • Arteriovenous malformation (AVM).
  • Dural arteriovenous fistula.
  • Development anomaly venous (DVA).
  • Telangiectasia hair.

For people who have the sporadic form, it is common to have a DVA and a CCM.

The ccm may leak blood and lead to bleeding in the brain or in the spinal cord, known as a hemorrhage. Bleeding in the brain can cause many symptoms, such as seizures.

Depending on the location, the Ccm can also cause stroke-like symptoms such as problems with movement or sensation in the legs and sometimes the arms. The ccm can also cause bowel and bladder symptoms.

Symptoms

Cerebral cavernous malformations (Ccms) may not cause symptoms. Sometimes, when the MCP occurs on the outer surface of the brain, can cause seizures.

And the Mcp is found in other areas may have a variety of symptoms. These include the Mcp in the spinal cord, the brain stem involvement of the spinal cord and the brain, and the basal ganglia in the interior of the brain. For example, bleeding in the spinal cord can cause bowel and bladder symptoms, or problems with movement or sensation in the legs or arms.

Usually, the symptoms of Ccm may include:

  • Seizures.
  • Strong headaches.
  • Weakness in the arms or legs.
  • Numbness.
  • Difficulty speaking.
  • Poor memory and attention.
  • Problems with balance and walking.
  • Changes in vision, such as double vision.

The symptoms may get worse over time, with repetition of the bleeding. The bleeding may occur again shortly after the first purge, or much later. In some people, a repetition of bleeding may never occur.

When to see a doctor

Seek medical help right away if you experience any of the symptoms of a seizure. Also seek medical help right away if you have symptoms that suggest a cerebral cavernous malformation or cerebral hemorrhage.

Causes

The majority of cerebral cavernous malformations (Ccm) are known as the "sporadic." Appear as a single malformation without any family history. The sporadic form often has an associated developmental anomaly venous (DVA), which is an irregularity of the vein with a witch's broom appearance.

However, about 20% of people with the CCM has a genetic form. This form is transmitted in families, such as the cavernous malformation syndrome. People with this form you can have family members with the Mcp, most often with more than one malformation. A diagnosis can be confirmed by a genetic test that requires a blood or saliva sample. Genetic testing is often recommended for people who have:

  • Mri evidence of multiple Ccm without a DVA.
  • A history of the family of the Mcp.

Radiation to the brain or to the spinal cord can also result in the Mcp in the period from 2 to 20 years later. Other rare syndromes may be associated with CCM.

Risk factors

The majority of cerebral cavernous malformations (Ccm) does not have a clear cause. But the form that is passed down through families can cause several of the Mcp, so to begin with, and over time.

To date, research has identified three genetic changes responsible for cavernous malformations that are transmitted through families. Almost all the relatives of the cases of cavernous malformations have been traced through genetic changes.

Family of Ccms are transmitted in families through a change in one of these genes:

  • KRIT1, also called CCM1.
  • CCM2.
  • PDCD10, also called CCM3.

These genes are responsible for affecting the permeability of the blood vessels, and proteins that keep the cells of the blood vessels together.

Complications

The most serious complications of cerebral cavernous malformations (Ccm) mother of recurrent bleeding, known as bleeding. The mcp that bleed over and over again can cause a hemorrhagic stroke and lead to damage in the nervous system.

The bleeding is more likely to return in people with prior bleeding. The bleeding is also more likely to happen again with the Mcp located in the brainstem.

Diagnosis

Often, people with cerebral cavernous malformations (Ccms) have no symptoms. The CCM can be found as a result of brain imaging for another condition. Sometimes the specific symptoms may ask your health professional for more testing.

Tests

Depending on the reason for the suspicion, your healthcare provider may order tests to confirm the Ccm or to identify or rule out other related conditions. You may have imaging tests to detect changes in the blood vessels. Your healthcare provider may also order tests if you have been diagnosed with a CCM and have new symptoms. The tests can show if there is bleeding or a new Mcp.

  • Magnetic resonance imaging (MRI). In this test, a detailed image of your brain or the spine. Sometimes a contrast dye is injected into a vein in the arm.
  • The genetic testing. If you have a family history of the disease, genetic counseling and the blood or saliva tests can help to find the changes in genes related to the Ccm.

Treatment

Cerebral cavernous malformations (Ccm) are treated by specialists. They may include:

  • Doctors trained in brain and nervous system conditions, known as neurologists and stroke neurologists.
  • Doctors trained in brain and nervous system surgery, known as neurosurgeons.
  • Doctors trained in brain imaging, known as neuroradiologists.

Physicians trained in other specialties, may also be involved in your treatment.

Your health care team reviews the symptoms and imaging tests to decide on a plan of treatment. The health care team may recommend watching the cavernous malformation is recommended. Or your health care team may recommend the elimination or treatment of the cavernous malformation. There are several options for the treatment of a cavernous malformation surgically. And the research is looking for drugs that can reduce the risk of bleeding.

If you have seizures related to a cavernous malformation, you may be prescribed medications to stop seizures.

If your treatment plan includes surgery, the most advanced imaging technologies can be useful. You can have a functional magnetic resonance imaging, which measures the blood flow in the active parts of the brain. Another option is to tractography, which creates a map of the brain that make surgery as safe as possible.

The prognosis of cerebral cavernous malformations depends on many factors, including their size, growth, and if they cause symptoms. Some Ccms do not cause any symptoms at all, while others can cause serious bleeding in the brain.

Potential future treatments

The experts are looking at the use of imaging technology to improve predictions of the evolution of the disease in some people. They are also looking into the use of images to obtain more information about a particular individual's disease state. These technologies include images using the quantitative mapping of susceptibility and permeability imaging using dynamic contrast-enhanced MRI.

There are several drugs that are being tested in clinical trials to see if the drug — specific rather than the surgery — could reduce the likelihood of bleeding. Talk with your health care professional about which clinical trials may be available to you.

Preparing for your appointment

Consult your health care professional if you have any symptoms that worry you. If a cerebral cavernous malformation is suspected, a referral to an experienced specialist can provide the best result.

Here's some information to help you prepare for the appointment, and what to expect from your health care professional.

What you can do

  • Maintain a detailed of the symptoms of the calendar. Each time a symptom occurs, write down the time, what you experienced, and how long it lasted.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Have a family member or friend. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who comes with you may remember something that you missed or forgot.
  • Bring any recent explorations of the brain in a CD to your appointment.

Also, if you have experienced seizures, your healthcare provider may want to ask questions to someone who has been a witness of them. It is common to not be aware of everything that happens when you experience a seizure.

Write questions to ask their health professional

Prepare a list of questions to help you make the most of your time. A list of questions from most important to least important. Here are some examples of questions to ask.

General questions

  • How many of cavernous malformations have?
  • Where is it, or where are they located?
  • What are the functions of the area or areas of the brain perform?
  • Should I have genetic testing?
  • Should my child or any other person in my family to be tested?

The management and observation

  • How often will I need follow-up tests?
  • With how often I'm going to follow up with you?

Surgery to remove a defect

  • What is the estimated time I would be in surgery?
  • How much recovery time of the surgery usually take?
  • How long should I be in the hospital?

Surgical history

  • How many Ccm've seen, and how many have tried?
  • Does your institution have stroke specialty practice?

Other questions may be useful for your needs. The Alliance to Cure the Cavernous Malformation offers a list of suggested questions.

Don't hesitate to ask any other questions during your appointment if you do not understand something.

What to expect from your doctor

It is likely that he will ask a series of questions:

  • When did you first begin experiencing symptoms? For example, when did the headaches, seizures, bleeding, or weakness in the arms or legs to start? When did you start to have problems with vision, balance, speech, memory or attention?
  • Do your symptoms come and go, or they are present all the time?
  • Do your symptoms seem to be triggered by certain events or conditions?

What you can do in the meantime

Certain conditions and activities that may trigger seizures, so that it can be useful for:

  • Do not drink alcohol in excess.
  • Do not use nicotine.
  • Get enough sleep.
  • Reduce stress.
Symptoms and treatment of Cavernous malformations