A cerebrovascular malformation is a rare condition that affects the blood vessels and blood flow in the brain. The condition can involve arteries, veins or both. Cerebrovascular malformations can involve one part of the brain or an entire half of the brain. Children with cerebrovascular malformations often undergo surgery to remove the abnormal blood vessels and restore normal blood flow in the brain.
Types of cerebrovascular malformations include:
- Arteriovenous malformations. These malformations involve arteries and veins but not capillaries. Instead of being connected by capillaries, the arteries and veins are tangled together. The abnormal mixing of blood between the arteries and veins can cause the vessels to enlarge. This can cause hemorrhaging and seizures.
- Cavernous malformations. Cerebral cavernous malformations (CCMs) consist of abnormal collections of thin-walled small blood vessels (capillaries) that displace normal tissue in the brain or spinal cord. These malformations are fragile, are prone to bleeding and can cause hemorrhage, seizures and neurological deficits. Hereditary forms of cerebral cavernous malformations can occur, resulting from genetic mutations in one of three disease genes: CCM1, CCM2 and CCM3.
- Venous anomalies. These cerebrovascular malformations affect just the veins. They include:
- Venous angiomas. These are veins that enlarge and twist together. They can be associated with cavernous malformations.
- Vein of Galen malformations. The vein of Galen moves blood away from the brain. The malformation starts during embryonic development and occurs when the vein of Galen does not develop a fibrous wall and is not supported by surrounding tissues. This weaker vessel can stretch and change shape and cause abnormal fetal blood circulation.
More than one cerebrovascular malformation can be present at the same time. Many of these conditions can be seen with radiologic diagnostic tests, such as a cerebral angiogram.
Cerebrovascular malformations may also occur with other conditions, including:
- Osler-Weber-Rendu syndrome (also called hereditary hemorrhagic telangiectasia), a genetic disorder that causes abnormal blood vessel formation
Symptoms of cerebrovascular malformations include:
If your child experiences any of these symptoms, neurologists and neurosurgeons will evaluate him or her for the signs of these conditions. An accurate diagnosis is important so that the right treatment is used.
Diagnosis of Cerebrovascular Malformation
Specialists with Riley at IU Health perform the following exams and tests to diagnose cerebrovascular malformations:
- Computed tomography (CT) scan.This is an X-ray scan that combines cross-sectional images to create highly detailed pictures of blood vessels and other body tissues.
- Magnetic resonance imaging (MRI).MRI combines radio waves and a magnetic field to create computer images of the body’s tissues and organs.
- Magnetic resonance angiography (MRA). In this test, a computer uses radio waves and a magnetic field to generate images of the body’s blood vessels.
- Magnetic resonance venogram. This imaging technique uses radio waves and a magnetic field to provide accurate pictures of the body’s veins.
If diagnostic tests show that a cerebrovascular malformation is present, a neurosurgeon will discuss with you the best treatment options for your child.
The goal of treatment for cerebrovascular malformations is to remove or repair abnormal blood vessels to prevent complications such as hemorrhage or stroke. Treatments include:
- Surgery. A neurosurgeon will determine the best surgical approach for your child’s specific condition. Options include:
- Resection. The neurosurgeon will carefully remove the abnormal blood vessels to restore normal blood flow and remove the risk of complications.
- Embolization.The neurosurgeon may place coils or use other methods to block blood flow in the abnormal blood vessels.
Children who undergo surgery for cerebrovascular malformations usually return home after a few days in the hospital. In most cases, they can return to normal daily activities within a month.
Key Points to Remember
Key Points to Remember
- Cerebrovascular malformations are a group of rare conditions that affect the blood vessels in the brain.
- Types of cerebrovascular malformations include arteriovenous malformations, cavernous malformations and venous anomalies.
- More than one cerebrovascular malformation can be present at the same time.
- Symptoms of cerebrovascular malformations include headache, seizure, hemorrhage and stroke.
- Surgery to remove or repair the abnormal blood vessels is the most common treatment.
Support Services & Resources
Support Services & Resources
View these links to discover support groups and more resources for cerebrovascular malformation.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This nonprofit group provides extensive information about the diagnosis and treatment of cerebrovascular malformation, including links to sites about clinical trials and research.
This National Institutes of Health website provides overview, diagnosis and treatment information about cavernous malformations.
The National Institute of Neurological Disorders and Stroke also provides detailed information about arteriovenous malformations.
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