Pathogenesis of “De Novo” Cavernous Malformations

Abstract

Cavernous malformations are vascular lesions presenting histologically as a collection of blood-filled spaces separated by a loose connective tissue network. Cavernous malformations may be familial or sporadic, both forms having a prevalence of around 0.5%. They account for between 8% and 15% of all cerebrovascular malformations, but are responsible for a disproportionately high percentage of symptoms. Although specific histological markers can distinguish different cerebrovascular malformations, there exist “mixed” lesions presenting histological features common to different forms, thereby giving rise to different theories as to the pathogenesis of cavernous malformations. We describe a young woman with a previously undetected lesion in the right temporal lobe revealed during follow-up MR investigation after resection of a skull base tumour. The lesion presented the typical MR features of cavernous malformation. The literature on the topic is reviewed, discussing the different pathogenetic hypotheses for “de novo” cavernous malformations.