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A CCM is a tangle of malformed blood vessels located in the brain and/or spinal cord. The vessels are weak and lack supporting tissue, thus they are prone to bleed. If seen under a microscope, a cavernous malformation appears to be composed of fairly large blood-filled “caverns.” A CCM is characterized by a slow bleed, or ooze, as opposed to the sudden rupture of an aneurysm. However, depending on the size and location of the CCM, and the frequency of the bleed, it can be just as dangerous.
Cerebral Cavernous Malformations are usually very distinct from the surrounding brain tissue and resemble a mass that looks like a blood clot. Generally, the lesion will push normal brain out of its way as opposed to incorporating brain tissue within it making it easier for the neurosurgeon to define its boundaries during surgery.
There is a theory that vascular malformations can occur many years later following radiation therapy to the brain. Additionally, there is also the theory that severe or repeated head trauma can cause cerebral capillaries to bleed. Over time, and in order for the brain to repair itself, it will develop a lesion in an attempt to control the bleeding. Researchers and doctors believe that these theories may answer the question why some people develop the sporadic form of CCM. However, since 1999, researchers have discovered one of the three suspected genes that cause the inherited form of CCM; also known as the familial form.
The size of the malformation varies greatly and can change depending on the amount and severity of each bleed. Typically, they range from something microscopic and can grow to the size of an orange.
While it is often that people are diagnosed with multiple lesions, many go on to live very happy, healthy and active lives. Not all malformations bleed and not all bleed with the severity or intensity that would require surgery. It is possible, depending on the size and the location of the lesion, that the blood will reabsorb causing symptoms or deficits to disappear. It is extremely important, however, to understand that brain stem lesions can be life-threatening.
There are additional types of vascular malformations that occur in the brain and other parts of the body. They are aneurysms, arteriovenous malformations (AVMs), venous malformations (VMs), and capillary telangiectasia. Each malformation has its own set of characteristics, and a bleed in these malformations occurs differently for each specific type. Because aneurysms and AVMs are more common and well-known, much research is already being done in this area. However, since CT Scans and MRIs are very accessible to the public today, more and more people are being diagnosed with Cerebral Cavernous Malformations, or CCM.
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