Cavernous Heangioma

  Topic Area: Cavernous Heangioma
  I'm a 29-year-old woman with two young children. Four weeks ago I was diagnosed with a cavernous heangioma on the left frontal lobe of my brain, which is approximately two centimeters by three centimeters in size, extending from the cortical area down to the ventricle. It is near my speech and language area, but apparantly quite accessible. I have had two opinions from neurosurgeons --one says wait and watch, while the other one says to eliminate the risk of further hemmorhage with excision. The MRI scan reveals some previous hemmorhage, which I've learned is quite common.
  The reason I initially went to a neurologist was because of very infrequent (6 total in 6 years), but severe, "spells" of dizziness, followed by 2 to 3 weeks of needing to concentrate more on my speech. At first I was told that this had nothing to do with the cavernoma,given its location. But the second surgeon says it may be related to when the cavernoma "leaks." He seems to think that these "spells" could be more like seizures--or focal seizures. I had an EEG (my first) both asleep and awake, and the results were within normal ranges. Even if they are not seizures, the second neurosurgeon says he still would recommend surgery because of my age and the 2-3% per year risk of hemmorhage.
  So my question is two parts:
  1. Have you ever heard people describe seizures as vertigo?
  2. Would you recommend the wait and watch approach or the surgical approach?
  I am very THANKFUL for your response!!!

[CCF Neurosurgery MD/GM]

Dear Jana:
Cavernous hemangiomas present in one of two ways. They either bleed or the cause seizures. Seizures can also be caused by the leaking of blood from the malformation. It sounds like you have had some symptoms that can be attributed to at least a seizure if not bleeding. My recommendation would be to have the cavernoma removed because of your age and if this is certainly accessible.
I hope this helps! GOOD LUCK