Radiation Oncology/CNS/Cerebral Cavernous Malformation

• Cavernous hemangiomas located in the brain

• Referred to as cerebral cavernomas or more usually as cerebral cavernous malformations (CCMs)

• Can be found in the white matter

• Often abut the cerebral cortex

• Can represent a potential seizure focus

• Can change in size and number over time

• Asymptomatic lesions may not require treatment but need to be monitored for any change in the size

• Treatments for cerebral cavernous hemangiomas include radiosurgery or microsurgery

Poorthis et al. (2013) Treatment of cerebral cavernous malformations: a systematic review and meta-regression analysis

• Ovid Medline, EMBASE and The Cochrane Library searched for peer-reviewed publications: 63 cohorts involving 3424 patients

• The incidence of the composite outcome was 6.6 (95% CI 5.7 to 7.5) per 100 person-years after neurosurgical excision (median follow-up 3.3 years) and 5.4 (95% CI 4.5 to 6.4) after stereotactic radiosurgery (median follow-up 4.1 years)

• Conclusion: (1) The reported risks of CCM treatment (and the lower risks of neurosurgical excision over time, from recently bled CCMs, and for CCMs outside the brainstem) compare favourably with the risks of recurrent haemorrhage from CCM (2) Long-term effects, especially important for stereotactic radiosurgery, are unknown