Natural history of intracranial cavernous malformations

TLDR

The study investigated the rate of subsequent symptomatic bleeding in intracranial cavernous malformations in relation to age at onset, sex, and lesion location. The authors reviewed 110 patients with intracranial cavernous malformations over a mean 4.71‑year follow‑up, categorizing them by presentation into hemorrhage, seizure, and incidentally diagnosed groups. They found a high rate of symptomatic bleeding in the hemorrhage group—especially among younger females—while nonhemorrhagic‑onset cases had a very low incidence, with generally good outcomes except for lesions in the basal ganglia and brainstem, informing therapeutic strategy.

Abstract

✓ The authors have reviewed the clinical records of 110 patients with intracranial cavernous malformations diagnosed by histological examination and/or magnetic resonance imaging over a mean follow-up period of 4.71 years. These cases were divided, based on their presentation, into a hemorrhage group, a seizure group, and an incidentally diagnosed group. The rate of subsequent symptomatic bleeding was investigated in relation to age at onset, sex, and location of the initial lesion. A high rate of subsequent symptomatic bleeding episodes was found in the hemorrhage group, especially among younger females. The nonhemorrhagic-onset cases had a very low incidence of bleeding. The outcome was generally good, except in patients with lesions in the basal ganglia and brainstem. These findings will be helpful in planning a rational therapeutic strategy for intracranial cavernous malformations.