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Bengt Karlsson, Lars Kihlström, Christer Lindquist, Kaj Ericson, and Ladislau Steiner

G amma knife radiosurgery (GKRS) has been used for the treatment of arteriovenous malformations (AVMs) since 1970; 21 the favorable results 20 of this procedure prompted pilot series in which GKRS was used to treat venous angiomas 15 and cavernous malformations (CMs). 24 We first used GKRS to treat a patient with a CM in 1985. In the first half of the present series, we used radiation doses comparable to those used in the treatment of AVMs. This resulted in a high incidence of complications, and we changed the protocol to lower radiation doses for the

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Bruce E. Pollock, Yolanda I. Garces, Scott L. Stafford, Robert L. Foote, Paula J. Schomberg, and Michael J. Link

C avernous malformations are vascular lesions that comprise the majority of vascular malformations diagnosed in the modern neuroimaging era 25 even though they are not visualized on cerebral angiography. Cavernous malformations have a typical appearance on MR imaging that has allowed a better understanding of their incidence and natural history. 22 Symptomatic CMs may signal their presence with bleeding or seizures, or they may be identified by incidental findings on MR images. 17 Microsurgical resection of CMs is the preferred management for patients with

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Joseph L. Voelker, Daniel H. Stewart, and Sydney S. Schochet Jr.

V ascular malformations are developmental anomalies that occur when embryonic vascular networks fail to differentiate. 25, 35, 48 Cavernous malformations (CMs), which are also termed cavernous hemangiomas, cavernous angiomas, and cavernomas, are one type of vascular malformation. They are found within the parenchyma of the central nervous system, in intracranial, extraaxial locations, in bone, especially the vertebrae and skull, and in soft tissues of the body. Published reports typically deal with solitary lesions involving only one area of the body

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Richard S. Zimmerman, Robert F. Spetzler, K. Stuart Lee, Joseph M. Zabramski, and Ronald W. Hargraves

I n 1966, McCormick 8 outlined four types of vascular malformations: arteriovenous malformations (AVM's), venous malformations, capillary telangiectasias, and cavernous malformations. The latter have recently received considerable attention because their distinct appearance on magnetic resonance (MR) imaging has allowed them to be recognized with increasing frequency, especially in the posterior fossa. 10, 11 Cavernous malformations have thus been analyzed closely. Studies detail their radiographic characteristics, 4, 10, 11, 18 the occurrence of solitary

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Masanori Yoshino, Akio Morita, Junji Shibahara, and Takaaki Kirino

C avernous malformations in the brain or spinal cord are thought to be congenital in origin; nevertheless, there is increasing evidence that these lesions are acquired, including a few cases involving de novo formation of cavernous malformations in the brain after cranial radiation treatment. 4, 7, 8, 14 Spinal cord cavernous malformation found after irradiation treatment is, however, extremely rare. 9, 11 We report a case of spinal cord cavernous malformation in which the patient presented with progressive symptoms after radiation treatment for a spinal

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Bradley A. Gross, Rose Du, A. John Popp, and Arthur L. Day

, 3 , 10 , 23 , 25 , 28 , 30 , 36 , 50 allowing for the possibility of a meaningful review. Herein, we comprehensively analyze the epidemiology, natural history, clinical presentation, and surgical results of these lesions. Methods A PubMed search was performed using the terms “spinal,” “intramedullary,” “cavernoma,” “cavernous malformation,” and “cavernous hemangioma.” Surgically and conservatively treated patient series were selected for review to amalgamate data on the natural history, clinical presentation, and surgical results for these lesions. For

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Prithvi Narayan and Daniel L. Barrow

C avernous malformations of the spinal cord are rare lesions of the CNS and comprise approximately 5 to 12% of all spinal vascular abnormalities. 5, 37, 41, 47 These angiographically occult lesions are well circumscribed and consist of thin-walled, dilated capillary spaces without intervening brain or spinal tissue. Within the spinal canal, they can be extradural, intradural extramedullary, or intramedullary. 2, 17, 20 Approximately 10% of all intramedullary cavernous malformations present in the pediatric population. 10 The lesion may produce no symptoms

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Wael F. Asaad, Brian P. Walcott, Brian V. Nahed, and Christopher S. Ogilvy

C avernous malformations are vascular lesions of the CNS with an estimated prevalence of 0.4–0.9% in the general population. 14 , 29 , 38 , 46 The proportion of CMs occurring in the brainstem is difficult to determine precisely, as brainstem lesions are more likely to be symptomatic than similar lesions in the cerebral hemispheres. Therefore, it is presumed that a disproportionate number of brainstem CMs come to clinical attention. Cavernous malformations are believed to cause symptoms in several ways. They are implicated in the etiology of a patient

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Ezequiel Goldschmidt, Andrew S. Venteicher, Maximiliano Nuñez, Eric Wang, Carl Snyderman, and Paul Gardner

presented concern for multiple approaches; here we see a FIESTA sagittal where again you can see the central location of the cavernous malformation. High-def fiber tracking was performed to try to understand the relationship of critical tracts. They showed lateral displacement of the motor fibers as well as third nerve tract, which made a ventral medial approach theoretically an ideal approach for this lesion. Endonasal and transcranial options were both considered; however, an interhemispheric transcallosal option was abandoned due to the location in the posterior third

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Richard T. Dalyai, George Ghobrial, Issam Awad, Stavropoula Tjoumakaris, L. Fernando Gonzalez, Aaron S. Dumont, Nohra Chalouhi, Ciro Randazzo, Robert Rosenwasser, and Pascal Jabbour

C erebral cavernous malformations are vascular malformations that consist of thin hyalinized vascular channels without intervening brain parenchyma. 27 , 34 These lesions are surrounded by hemosiderin deposits and a gliotic margin and may be thrombosed. 8 While their location is variable, 70%–80% of intracranial CMs have a supratentorial origin. 8 With the increasing availability of MR imaging, the diagnosis of CM has risen significantly. In fact, prior to MR imaging, CMs were uncommon, and their evaluation and management were described only in case