Cavernous angioma

Hemangioma, cavernoma, malformation – all these are names of such a very dangerous disease as cavernous angioma. The disease is a vascular defect, mainly of a congenital nature.

The pathology can be discovered at any age by chance, or manifest itself as severe neurological disorders.

[ 1 ], [ 2 ], [ 3 ], [ 4 ]

Causes cavernous angioma

Cavernous angioma can be congenital or sporadic. The pathogenesis of the congenital type of the disease is considered to be more studied. At the moment, there is evidence of an autosomal dominant type of inheritance, and certain genes of the seventh chromosome have been discovered and identified, which, when modified, cause the formation of pathological vascular bundles.

Experiments with the discovered genes have demonstrated that the formation of cavernous angiomas is predetermined by a disorder in the formation of endothelial cell structures. It is assumed that the proteins encoded by certain genes function in one direction.

The causes of sporadic angiomas have not yet been identified. There are only theoretical guesses put forward by many scientists. However, there is currently no clear evidence for such theories:

• theory of radiation-induced formations that arise as a result of irradiation;
• immune-inflammatory, infectious theory of pathology.

[ 5 ], [ 6 ], [ 7 ]

Pathogenesis

The diameter of angiomas can vary greatly – from a few millimeters to several centimeters. The most common type of formation is about 20-30 mm in size.

The malformation can be localized in any part of the central nervous system:

• 80% of angiomas are located in the upper parts of the brain;
• 65% of them are located in the frontal, temporal and parietal lobes;
• 15% are accounted for by vascular formations of the thalamus and basal ganglia;
• 8% is cerebellar angioma;
• 2.5% choroid plexuses in the spinal cord.

[ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ]

Symptoms cavernous angioma

The symptoms of the disease mainly depend on where exactly the formation is located. One of the more characteristic signs is considered to be epileptic seizures in combination with acute or subacute neurological symptoms. The first signs can appear simultaneously with general cerebral manifestations, as well as independently:

• headache, which at first may be weak and transient, later developing into a severe pain that cannot be eliminated by conventional medications;
• convulsive attacks resembling epileptic ones;
• a sensation of noise or ringing inside the head or in the ears;
• unsteady gait, impaired motor coordination;
• dyspeptic disorders in the form of attacks of nausea and vomiting;
• development of paralysis, weakness and numbness of the limbs;
• deterioration of visual and auditory function, memory and attention disorders, speech impairment, confusion of thoughts.

There are often cases when cavernous hemangioma does not manifest itself with any signs. A large number of people can live without even knowing about their disease. In such patients, the disease is found during the diagnosis of other pathologies, during preventive studies, or when angioma is detected in close relatives.

[ 16 ], [ 17 ]

Forms

As we have already said, the symptoms of cavernous angioma largely depend on the location of the vascular formation and its size. Manifestations of the disease occur when a bundle of vessels begins to press on the surrounding tissues and nerve endings in certain areas of the brain.

• Cavernous angioma of the frontal lobe, in addition to standard symptoms, may be accompanied by disorders of self-regulation of mental activity. The fact is that the frontal areas of the brain are responsible for motivation, setting and achieving goals, controlling one's actions and evaluating the result. Patients' memory deteriorates, handwriting changes, and uncontrolled extra movements of the limbs appear.
  • Cavernous angioma of the left frontal lobe produces such a symptom as a speech regulation disorder: a person's vocabulary becomes poor, he forgets words, and speaks extremely reluctantly; there is apathy and no initiative.
  • Cavernous angioma of the right frontal lobe, on the contrary, is characterized by excessive speech activity. The patient may periodically enter a state of affect, he becomes emotional and sometimes even inadequate. The patient's mood is mostly positive - he often does not realize that he has a disease.
• Cavernous angioma of the left temporal lobe is accompanied by hearing and speech disorders. The patient has poor memory and perceives other people's speech worse by ear. At the same time, in his speech, he often and unconsciously repeats the same words several times.

Cavernous angioma of the right temporal lobe may manifest itself with the following symptoms:

• the patient stops identifying the sounds and cannot recognize the origin of a particular noise. The same applies to voices: a previously familiar voice may seem alien.

Cavernous angioma of the parietal lobe is often characterized by so-called intellectual disorders. The patient loses the ability to solve simple mathematical problems, forgets the elementary rules of division-multiplication, subtraction and addition. Logic and the ability to think technically are lost.

Cavernous angioma of the cerebellum sometimes occurs with pronounced symptoms - this is an unsteady gait and even sitting, inadequate positions of the head and body (strange tilts, poses). Visible impairment of speech function, nystagmus, convulsions, contractures.

• Thrombotic cavernous angioma is usually caused by an infectious disease that spreads mainly from the sinuses and nasal cavity. Symptoms include increased body temperature, weakness, hyperhidrosis, fever. All this occurs simultaneously with the standard signs of angioma, depending on the location of the vascular formation.

There is another type of angioma that often raises questions among patients - this is a cavernous angioma with an abundance of hemosiderophages. What are we talking about?

Hemosiderophages are specific macrophage cells that contain hemosiderin, an iron-containing pigment. The presence of these cells means that the resorption process is taking place in the pathological focus: siderophages appear on the 3rd-4th day from the beginning of the process and are destroyed approximately on the 17th-18th day. Resorption is the absorption of the decaying erythrocyte mass, in which macrophages take an active part. The maturity of hemosiderophages can be used to determine the duration of the inflammatory lesion in the angioma.

[ 18 ], [ 19 ], [ 20 ]

Complications and consequences

What consequences or complications can a cavernous angioma cause? This directly depends on which part of the brain the vascular cavernoma is located in, its size, the progression of the pathology, the patient's lifestyle, and many other factors. If the malformation is detected too late, or an inflammatory or dystrophic process develops in it, complications may soon arise: ruptures of the vascular wall, hemorrhages, an increase in the volume of vascular clusters and caverns, local blood flow disorder, cerebrovascular accident, and death.

However, sometimes a patient can live with such a pathology and not suspect its existence. But is it worth hoping for, because cases are different, and no one is immune from undesirable manifestations of the disease. This also applies to cavernoma - this disease is unpredictable, and no one can say how it will behave in the future. Therefore, doctors clearly advise: even in the absence of clinical manifestations, it is important to regularly monitor the progression and condition of the vascular cavernous formation, control its development and periodically undergo a course of preventive treatment prescribed by the doctor.

[ 21 ], [ 22 ]

Diagnostics cavernous angioma

Treatment of cavernoma should always begin with a full diagnostic procedure, the scheme of which doctors determine individually for each patient. The general diagnostic method may include the following types of research:

• Comprehensive blood tests (for the presence of an inflammatory process, anemia), as well as cerebrospinal fluid tests (for the presence of hemorrhages in the cerebrospinal fluid).

Instrumental diagnostics:

1. angiography method – X-ray examination of blood vessels using a contrast fluid. The resulting image will help detect the degree of narrowing or destruction of brain vessels, identifying changes in the vascular wall and revealing weak points. This diagnostic procedure is prescribed to determine circulatory disorders in the brain. It allows you to clearly determine the location, volume and shape of the angioma, as well as detect the damaged vessel. Diagnostics are carried out in a specially equipped room. First, the doctor administers local anesthesia, after which he penetrates the vessel with an elastic catheter and advances it to the affected area. The contrast agent introduced into the circulatory system spreads along the vascular network, after which the doctor takes several images, which are subsequently used to establish a diagnosis;
2. the computed tomography method is a very popular painless procedure that does not cause discomfort and is quite informative. It is usually performed both with and without a contrast agent. As a result, the doctor receives detailed layered X-ray images in the form of two-dimensional images, which allows for a detailed examination of the pathology. The procedure is performed only in special rooms with the appropriate equipment - a tomograph;
3. the magnetic resonance imaging technique is somewhat similar to computed tomography, but instead of X-rays, radio waves and magnetic radiation are used. The images are detailed and three-dimensional. The procedure is non-invasive, provides comprehensive information about the disease, but is relatively expensive;
4. The electroencephalography method allows to study the biological potentials of the brain, as well as to determine where the angioma is located and what its size is. If a neoplasm is present, the doctor detects a change in the signal sent to the brain structures.

[ 23 ], [ 24 ], [ 25 ]

Differential diagnosis

Differential diagnostics are usually performed with other tumors or with an aneurysm - if a rupture is suspected, the patient is prescribed a cerebrospinal fluid test in the hospital. The analysis will allow detecting traces of bleeding or hemorrhage in it. Such a procedure can only be performed in a hospital setting.

Additionally, examinations and consultations with other specialists, such as a vascular surgeon, neurosurgeon, neuropathologist, geneticist, etc., may be prescribed.

Treatment cavernous angioma

Surgical treatment is the most effective option for treating cavernoma. There is no universal medicine that could eliminate the pathology.

Prescribing treatment is often complicated by the fact that many patients do not experience any discomfort from cavernous angioma, and persistent disability is generally observed only with repeated hemorrhages from deep-seated angiomas or from neoplasms of the brain stem – areas that are difficult to access for surgical intervention.

However, even a benign course of the disease does not guarantee the absence of complications in the future, and timely surgery can completely eliminate the risk of negative consequences.

Thus, experts recommend surgical treatment in the following situations:

• in superficial cavernous angiomas, which manifest themselves as hemorrhages or convulsive attacks;
• in neoplasms that are located in active brain areas and are manifested by hemorrhages, persistent neurological disorders, and epileptic seizures;
• if the angioma is of dangerous size.

In any case, the doctor must inform the patient about all possible risks and options for the course of the disease.

Surgical treatment of cavernous angioma can be carried out in several ways:

• Surgical intervention is a classic method of removing neoplasms, which will reduce the pressure of the vascular bundle on the surrounding brain tissue, which will eliminate unpleasant symptoms and the risk of rupture of pathological vessels. It has some contraindications: old age and multiple vascular formations.
• Radiosurgical intervention is the removal of a tumor using special devices (cyber gamma knife). The essence of the method is that a beam of radiation aimed at a certain angle acts on the angioma. This procedure is considered safe, but not as effective as surgery. This method is used mainly in cases where surgery is impossible or difficult due to the inaccessibility of the angioma.

Traditional treatment of cavernous angioma

Herbal treatment of cavernous angioma is used only to alleviate the symptoms of the disease. It is foolish to hope that taking herbal remedies will help to completely get rid of the problem - we repeat once again that the only radical treatment for angioma is surgery. However, before starting such treatment, it is still recommended to consult a specialist.

• To prevent vascular wall ruptures, it is recommended to increase its elasticity. This can be achieved by consuming 2 tablespoons of any vegetable oil daily on an empty stomach (one spoon in the morning, the second at night). Olive or linseed oil, as well as unrefined sunflower oil, are used.
• Another common method used to increase the elasticity of blood vessels is to take a mixture of equal parts of natural honey, vegetable oil, flaxseed and lemon juice on an empty stomach every morning.
• To improve blood circulation, the following recipe may be useful: take one tablespoon of freshly squeezed potato juice every morning on an empty stomach. It is also recommended to drink rosehip infusion.
• To cleanse blood vessels and improve blood circulation, take a garlic infusion. Prepare it as follows: grate a head of garlic and one lemon (with peel) on a fine grater, mix, pour in 0.5 l of boiled cooled water and leave for 3-4 days. Drink 2 tbsp. daily. Can be stored in the refrigerator.
• To eliminate symptoms such as headaches, dill seeds help. It is necessary to pour a glass of boiling water over 1 tbsp. of seeds. Take 1 tbsp. 4 times a day.
• To get rid of dizziness and noise in the head, it is useful to drink tea made from mint or lemon balm several times during the day.
• To strengthen blood vessels, it is recommended to eat a couple of green olives once a day in the morning before breakfast.

[ 26 ], [ 27 ], [ 28 ], [ 29 ]

Homeopathy for cavernous angioma

Many patients with cavernous angioma prefer herbal remedies, such as homeopathic ones, as a replacement for traditional drug treatment. On the one hand, this is a good choice: homeopathic drugs have no side effects and rarely cause allergies, and their effectiveness is sometimes legendary. However, you should always be careful in your choice and consult with specialists - first of all, with your doctor.

What medications are recommended by homeopaths to relieve symptoms of cavernous angioma:

• Edas-138 is a product manufactured by the company "EDAS";
• Angiosan – produced by the company “Gomeofarma”;
• Cerebralik – manufacturer – Fitasintex company;
• "Aurum +" is a product from the company "Doctor-N".

If your doctor suspects possible complications and hemorrhages of angioma, then perhaps it is worth agreeing to surgery - any medications, folk or homeopathic, can relieve symptoms for some time, but the main problems - the vascular bundle and circulatory disorders - will remain.

Prevention

Prevention of cavernous angioma, as a congenital disease, is impossible, since there is currently no way to correct the genetic disorder.

When talking about preventive measures, doctors usually mean preventing complications of the disease – rupture of blood vessels, bleeding, etc.

What are the recommendations for this?

• Constant monitoring of blood pressure (normal range: from 120/80 to 140/90).
• Proper nutrition, no excess weight.
• Controlling cholesterol levels in the bloodstream.
• Absence of bad habits.
• Regular blood glucose testing.
• Absence of stress and psycho-emotional shocks.
• Moderate physical activity.
• Adherence to an anti-cholesterol diet (with limited animal fats and predominant consumption of plant-based and lean foods).

It is necessary to listen to your body. At the slightest sign of a disorder of brain activity - if headaches, dizziness, hearing or vision impairments, numbness of the limbs, etc. - it is imperative to consult a doctor. Timely treatment significantly improves the prognosis of the disease.

[ 30 ], [ 31 ], [ 32 ], [ 33 ]

Forecast

The prognosis for cavernous angioma can generally be called favorable, but only if the disease is detected before the vessel ruptures with hemorrhage, and also if surgical intervention to remove the neoplasm is performed in a timely manner.

After surgical treatment and radiosurgery procedures, the patient can soon lead a full life. After the removal of the cavernous formation, all patients are completely free of pathological symptoms and discomfort.

Currently, most well-known clinics are equipped with the most modern devices for diagnostics and treatment of such pathology as cavernous angioma. The treatment regimen is prescribed taking into account the individual characteristics of patients, based on the results of diagnostic examinations.

[ 34 ]