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Background <p>Cerebral cavernous malformations (CCMs) are vascular anomalies consisting of clusters of thin walled blood vessels, missing intervening brain parenchima, the pathogenesis of which leads to repeated episodes of hemorrhage and thrombosis. This in turn may have a clinical impact, resulting in acute intraparenchymal hemorrhage (IPH), seizures, headaches, and focal neurological signs (FNS), but they can also be discovered purely incidentally.</p> Objective <p>To review current treatment modalities for CCMs and evaluate the potential of emerging pathogenic-targeted therapies.&#xa0;Methods: A comprehensive review was conducted to summarize existing therapeutic strategies for CCMs, broadly separated in conservative measures with clinical and imaging monitoring,&#xa0;microsurgical resection (MRS), and stereotactic radiosurgery (SRS). The influence of clinical presentation, lesion location (eloquent vs. non-eloquent brain areas),&#xa0;and patient-specific factors (age and comorbidities) on treatment decisions is discussed.</p> Results <p>The clinical presentation and location of the CCM (eloquent or non-eloquent brain area), its association with a developmental venous anomaly&#xa0;(DVA),&#xa0;and the patient’s age and comorbidities are cornerstones in choosing an optimal strategy, but controversy remains regarding specific criteria involved in decision-making tailored for each patient.</p> Conclusions <p>This review focuses on advantages and limitations of each current practice,&#xa0;the importance of a careful balance between clinical and anatomical considerations,&#xa0;while also presenting pathogenic treatment options currently under investigation, such as beta blockers, Rho-kinase (ROCK) inhibitors, and superoxide dismutase (SOD) mimetics.</p>

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A Review of Current Advances in the Treatment of Cerebral Cavernous Malformations

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月23日

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  • Adriana Octaviana Dulamea,
  • Andra Madalina Ene

摘要

Background

Cerebral cavernous malformations (CCMs) are vascular anomalies consisting of clusters of thin walled blood vessels, missing intervening brain parenchima, the pathogenesis of which leads to repeated episodes of hemorrhage and thrombosis. This in turn may have a clinical impact, resulting in acute intraparenchymal hemorrhage (IPH), seizures, headaches, and focal neurological signs (FNS), but they can also be discovered purely incidentally.

Objective

To review current treatment modalities for CCMs and evaluate the potential of emerging pathogenic-targeted therapies. Methods: A comprehensive review was conducted to summarize existing therapeutic strategies for CCMs, broadly separated in conservative measures with clinical and imaging monitoring, microsurgical resection (MRS), and stereotactic radiosurgery (SRS). The influence of clinical presentation, lesion location (eloquent vs. non-eloquent brain areas), and patient-specific factors (age and comorbidities) on treatment decisions is discussed.

Results

The clinical presentation and location of the CCM (eloquent or non-eloquent brain area), its association with a developmental venous anomaly (DVA), and the patient’s age and comorbidities are cornerstones in choosing an optimal strategy, but controversy remains regarding specific criteria involved in decision-making tailored for each patient.

Conclusions

This review focuses on advantages and limitations of each current practice, the importance of a careful balance between clinical and anatomical considerations, while also presenting pathogenic treatment options currently under investigation, such as beta blockers, Rho-kinase (ROCK) inhibitors, and superoxide dismutase (SOD) mimetics.