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Open access

Carmen R. Holmes, Giuseppe Lanzino, and Kelly D. Flemming


Little is known about whether coronavirus disease 2019 (COVID-19) influences cavernous malformation (CM) formation or hemorrhage risk.


The authors present the case of a 31-year-old patient who developed a hemorrhagic, de novo CM in the setting of a developmental venous anomaly within 3 months of COVID-19 respiratory disease. The authors speculate that COVID-19 disease stimulated formation of the CM through TLR4 inflammatory pathways and subsequently led to the hemorrhagic presentation because of hypercoagulability related to the disease.


This case raises the possibility that COVID-19 may be a risk factor for de novo development of CMs in predisposed patients.