Vascular Malformations of the Brain

Causes

Cavernous malformations appear to be congenital -- that is, a patient is born with them -- although there are several instances where their development over time has been carefully documented by serial MRI scans. Lesions that are microscopically similar to cavernous angiomas can occur years following radiation therapy to the brain for the treatment of leukemia or tumors of the brain, implying that some type of injury to blood vessels by the radiation therapy may lead to the development of these malformations in susceptible individuals.

In studies based at Boston Children's Hospital, about 25 percent of patients had a strong family history of cavernous malformations. A family history component is likely if other family members have had hemorrhages within the brain at an early age, if multiple members of a family have a seizure disorder, or if there are associated blood vessel abnormalities on the skin. If a child has multiple cavernous angiomas the likelihood of a positive family history also is higher than normal. In these cases, it may make sense to have siblings tested for cavernous malformations.

Once a CM is diagnosed, many parents want to know if physical activity will cause it to bleed. There is little evidence of any relationship between physical activity and bleeding episodes and many patients with cavernous angioma lead normal, active lives. Nonetheless, it may make sense to avoid high-impact activities such as football.