Cavernoma of the brain and spinal cord: consequences, contraindications, removal

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Cavernous hemangioma or cavernoma is a vascular formation that is a cavity filled with blood and bounded by a vascular wall. Such formations can have different sizes from a few millimeters to several centimeters.

Cavernomas can be localized in any part of the spinal cord or brain, however, they are most often detected in the vascular structures of the cerebral hemispheres. Such formations are dangerous for rupture and subsequent bleeding, which happens in 5-24% of cases.

Causes of the emergence of

Cavernous angiomas most often have an innate origin, although sporadic formations also occur. These are benign tumors that have a spongy structure, they are elastic and soft when pressed.

Under pressure, the tumor can completely disappear, and after that it again takes the previous forms. Such formations often bleed, which can lead to infection.

With the growth of the vessels of the tumor, it also increases. Sometimes the cause of the formation of cavernoma is a soft tissue injury, which provokes the formation of vascular neoplasms.

The etiology of the sporadic cavity is not known today, although there are suggestions that infectious, immune-inflammatory and radiation factors play a significant role in their development.

Symptoms and forms of

Cavernous angiomas can form in any tissues, however, the largest neurosurgical interest is tumors with cerebrospinal or spinal cord localization.

Such formations often cause hemorrhages and bleedings, which become the first manifestations of tumor formations.

If a bleeding occurs in the cerebrospinal or cerebrospinal stem, then severe neurologic disorders such as quadripares occur, etc.

Cavernous angiomas often develop asymptomatically. More often such formations are revealed in 20-40 years of age. In general, the cavernous clinic depends on the specific location of the tumor.

According to statistics, about 80% of the cavern is in the upper cerebral parts, about 8% in the cerebellum and about 2% of the tumors are located in the spinal vascular plexuses.

Cerebral Cortex

A headache cavity can be localized in the cerebellum, in the left, frontal, right or parietal, temporal lobe or brainstem.

Common signs of cavernoma are:

• Attacks of convulsive contractions, similar to epileptic;
• Headaches, initially weak, but over time intense and persistent, not amenable to drug-induced elimination;
• Shakiness of gait, motor disturbances;
• Weakness, numbness or paralysis of the limbs;
• Extraneous sounds in the ears, in the head;
• Dyspeptic disorders such as nausea and vomiting;
• Hearing and vision problems, disturbances of attention and memory, speech, confusion of thought processes, etc.

If the cavernoma is localized in the frontal lobe, then in addition to general symptoms, it is characterized by the presence of violations of mental self-regulation.

Since the frontal lobe controls the motivation, the actions performed, the setting and the achievement of goals, the evaluation of the results, then with this cavernoma localization the patient has memory problems, his limbs can perform involuntary movements, the handwriting changes markedly.

The legal cavernoma is characterized by the inability to determine the origin of sounds and noises, voices, etc. Even a previously familiar voice will seem to be a stranger.

Dark localizations of cavernous angiomas are manifested by intellectual disorders. When the cerebellum is affected, there is a shakiness of the gait, convulsions and nystagmus, violations of speech functions and contractures.

Spinal cord invertebrate

Spinal cavity cavernomas are detected much less frequently and are accompanied by vivid symptomatology:

1. The presence of severe disorders in spinal activity;
2. Vegetative disorders;
3. Disorders of conductor functions;
4. Against the background of multiple hemorrhages, motor disorders occur;
5. Malotytic dysfunction;
6. Sensitivity disorders in some parts of the body.

Consequences of the tumor

The severity of the consequences of a cavernoma is due to the localization of the tumor, its size, the degree of development of the formation and the state of the patient's health.

If the pathology is detected late, or the tumor starts dystrophic changes or inflammation, then in the future it will cause complications like:

• Vascular gaps;
• Hemorrhages;
• Growth of cavern and vascular congestion;
• Local blood flow disorders;
• Disturbance of cerebral blood supply;
• Lethal outcome.

But it happens that patients live with a cavernoma all their lives and do not know about the disease. This pathology is unpredictable, so it's hard to say how it will show itself in the future.

Therefore, neurosurgeons recommend constantly being under medical supervision to timely notice the progression of the pathology, monitor its course and prevent possible complications.

Contraindications

In cavernous malformations, as with other vascular formations, it is contraindicated to have a direct physical effect on the location of the tumor, for example, physiotherapy sessions, massage and other procedures that give a warming effect and stimulate blood flow.

In addition, with such tumors, self-medication and the use of traditional medicine are inadmissible, since an incorrect approach to therapy can provoke a hemorrhage or rupture of tumor vessels.

Diagnosis of cavernous malformation

Diagnostic tests for cavernous angiomas include such procedures as:

1. Electroencephalography - a technique that examines cerebrospinal biopotentials. If the brain has any education, then these signals change;
2. CT is an X-ray study with good information;
3. MRI is the most informative diagnostic technique that allows you to accurately determine cavernous malformation in the cerebrospinal and cerebrospinal structures;
4. Angiography - giving a complete picture of pathologically altered vessels.

Treatment methods

Therapy of the cavernoma of the brain and spinal cord is based on surgical removal, because conservative treatment against such formations is powerless.

The operation may be complicated by the inaccessibility of the tumor or the refusal of the patient, to whom cavernous malformation does not cause trouble.

Doctors identify several factors in which surgery is essential:

• If the tumor is superficial and causes frequent seizures;
• If the tumor is large enough and localized in the hazardous area;
• If education in the past has already been the cause of hemorrhage or dangerous bleeding.

Operative treatment can be carried out using several methods.

1. Classical removal of , due to which the compression of brain structures ceases, and, therefore, the symptomatology of a tumor like neurological signs, seizures, etc. disappears. However, such removal is not performed for elderly patients, with multiple cavernous character and with concomitant decompensatory pathologies.
2. In addition to classical surgical removal, the tumor can be removed by radiosurgery using a gamma knife. In this operation, irradiation is effected by a beam of waves directly onto the tumor, without affecting adjacent tissues. This technique refers to the generally accepted for difficult to localize the tumor or its location in the vital brain departments. This approach ensures obliteration of the tumor and completely eliminates the risk of cerebral hemorrhage.
3. Remove cavernous angiomas and with laser therapy , when tumor tissue is removed layer by layer through laser exposure. The advantage of this technique is the minimal risk of scarring and bleeding, therefore this approach is considered to be a priority in case of superficial cavernous location;
4. Diathermocoagulation is especially recommended for the treatment of bleeding-prone lesions of small size. The removal is carried out by electric shock.
5. Cryotherapy. Removal is carried out by exposure to liquid nitrogen. Under the influence of low temperatures, tumor tissues seem to freeze;
6. Applies to cavernoma and hormone therapy. Similar treatment is used for rapid growth of formations, which stops and even regresses under the influence of anti-inflammatory and immunosuppressive effect of hormonal drugs. This approach helps to reduce the tumor size or helps to stop their intensive growth.
7. Sclerotherapy. This approach involves the introduction of sclerosing agents in the cavity of formation, resulting in the adhesion of its walls, the vessels fall off and become empty. This technique can significantly reduce the size of the tumor without surgery.

Rehabilitation after tumor removal

To recover more quickly after surgery with cavernoma, a patient needs to go through a complex of rehabilitation measures.

In accordance with the psychophysical condition, the patient is assigned rehabilitation and rehabilitation procedures. With the patient working masseurs and neurologists, physiotherapists and speech therapists, psychiatrists, etc.

With the correct professional approach of doctors, the persistence of the patient and the highly qualified equipment of the medical institution, recovery will be much faster.

Prophylaxis and prognosis of

If pathology is detected before complications such as vascular ruptures or cerebral hemorrhages, the predictions are positive. Quite quickly, patients recover and return to their former, full-fledged lifestyle.

The video shows the removal of the cavernoma of the brain stem: