Cavernomas of the Brain

Our clinical and surgical experience with 16 cases of cavernous hemangioma (cavernoma) of the brain is presented. In 50% of the cases, symptoms appeared during the 3rd decade of life. The clinical picture included seizures in 50% of the cases and a brain tumor-like syndrome in 37.5%, and 12.5% of the cases began with an intracerebral hemorrhage. In our series females predominated over males by 2:1. Computed tomographic (CT) scanning is the best procedure for the diagnosis of cavernomas. However, exact preoperative diagnosis of these lesions is infrequent because cavernomas are generally accepted to be very rare. A slightly hyperdense nodule, poorly enhanced after contrast administration, is the prominent feature on the CT scan. A small, hypodense zone surrounding the lesion and calcifications within the nodule are also found. An excellent result after operation was obtained in all cases of cavernoma located in the brain hemispheres. In deeply placed cavernomas (basal ganglia or brain stem), the surgical prognosis is doubtful, and features such as the size of the lesion and its anatomical location are important.