Cerebral Cavernous Hemangioma

Posted By Jana on May 11, 1998 at 13:09:51:







THANKS to this wonderful forum, a neurosurgeon responded to a question regarding my recently diagnosed cavernous hemangioma. The lesion is approximately 3.8 x 2 cm, is close to my speech and language area, has a dark ring around it on MRI, and extends from the cortical area down to the ventricle. Its size and shape a bit atypical, so there is a possibility that it is two contiguous lesions. The neurosurgeon who responded to the question I posted said that these lesions are typically excised if they are quite accessible. Could you also tell me:
* Do all cavernous hemangiomas have the dark ring around them on MRI? Or does that definitely signal true "hemorrhage?"
* What is the true hemorrhage rate? I've heard various statistics about the risk rates of hemorrhage. One study says that the risk is .25 to .7 percent each year, while others say more or less. I also understand that the rehemorrhage risk is significantly higher.
* Are hemorrhages life-threatening? What typically happens as a result of a hemorrhage?
* Would you still recommend surgery in a patient that is likely asymptomatic? The reason I originally visited a neurosurgeon 2 months ago was because of very infrequent (6 total in 6 years) spells of severe vertigo--room spinning accompanied by nausea and vomiting, and two to three weeks of feeling "unbalanced." However, I've been told that, given its location, it's likely not related. The only other time I could have had symptoms of hemorrhage was 6 years ago when I had a HORRIBLE headache and neckache that lasted for about a week.
Any further insight you could provide would be much appeciated. Thanks again for your response!
--Jana