Cavernous Malformations of the Brain: Natural History and Surgical Outcomes

Cerebral cavernous malformations (CCM) are rare, benignvascular anomalies of the central nervous system with aprevalence of 0.5–0.8%. While often discoveredincidentally, they may present with seizures, headaches,focal neurological deficits, or intracranial haemorrhage.Sporadic cases typically involve solitary lesions, whereasfamilial forms are associated with multiple lesions andgenetic mutations such as PDCD10. Supratentoriallocations predominate, but brainstem, cerebellar, andspinal involvement are also observed.Management depends on symptomatology and lesion site.Asymptomatic cases are generally observed with serialimaging, while symptomatic lesions may requireintervention. Microsurgical resection remains thetreatment of choice for patients with medically refractoryseizures or recurrent haemorrhage, offering favourablelong-term outcomes and high seizure control rates.Radiosurgery may be considered for deep or eloquentlesions where open surgery carries a higher risk, though itsbenefits are delayed. An individualized approach isessential to optimize neurological and functional outcomesin CCM.Keywords: Cavernoma, Cavernous malformation, Seizure,ICH, Microsurgery, Radiosurgery