1. Richard E. Clatterbuck, M.D., Ph.D.
Department of Neurological Surgery
Cavernous Malformations, Venous Malformations, and Capillary Telangiectasias
Richard E. Clatterbuck, M.D., Ph.D.
The Johns Hopkins University School of Medicine

3. Cavernous Malformations
Abnormal vascular channels lined by endothelial cells (cells that line all blood vessels) but lacking other components of typical blood vessel walls
Have been described as having an appearance similar to mulberries

4. AKA Cavernous angioma Cavernous hemangioma Cerebral angioma Cavernoma
Cavmals
CCMs (cerebral cavernous malformations)

8. Radiographic Appearance
Classically described as a “popcorn” lesion with a reticulated appearance on MRI scans

12. Epidemiology
Occur in 0.5% of the population (1 in 200 people) and may represent 10% of vascular malformations
Perhaps slightly more prevalent in females, 1.8:1 in our series

13. Presentation Mean age 34.6 years (7.8-78.5)
Average of 3.4 lesions per patient, solitary in 63% and multiple in 25%
19% had venous malformations
4% had capillary telangiectasias
Headache (65%), seizures (49%), focal deficits (46%), hemorrhage (13%), asymptomatic (1.5%)

14. Hemorrhage rates 3.1% per patient year hemorrhage rate 0.9% in males
4.2% in females
No difference in lesions in the cerebrum or brainstem

15. Seizure rates 4.8% per patient year
2.4% new onset seizure rate per patient year
5.5% recurrent seizure rate per patient year

16. Venous malformation
Persistence of a developmentally expressed venous drainage pattern
Classically described as a caput medusae appearance

17. AKA Developmental venous anomaly (DVA) Venous anomaly Venous angioma
Venous malformation

20. Presentation Mean age 39.1 years (18.7-73)
19% had another cerebrovascular malformations
Headache (50.8%), seizures (30.2%)

21. Hemorrhage rate
0.15% per lesion year

22. Capillary Telangiectasia
Normal capillary structurally at the cellular level but abnormal in size, dramatically dilated

23. AKA
Capillary malformations
Captels

26. Presentation
Much rarer lesions with unclear although certainly low hemorrhage rate
Present throughout life but typically in 3rd or 4th decade
Symptoms include headache, numbness, dizziness, visual disturbance

27. How are these related?

28. Cerebral Vascular Malformations
Cavernous malformation
Venous malformation
Capillary telangiectasia