CEREBRAL CAVERNOUS HEMANGIOMAS IN CHILDHOOD - CLINICAL PRESENTATION AND THERAPEUTIC CONSIDERATIONS

Cerebral cavernous hemangiomas (CCH) are relatively rare vascular hama rtomas. Since the introduction of MRI there has been an increase in th e number of case reports of CCH in the medical literature. CCH are oft en asymptomatic; they may, however, cause epilepsy or neurological def icits due to their space-occupying effects or hemorrhagic sequelae. Th e tendency of CCH to bleed has been well recognized, though gross hemo rrhage is infrequent owing to the relatively low blood pressure and sm all blood flow in CCH. MRI findings of a CCH are characteristic and ca n differentiate the lesions from other vascular abnormalities. To date , there has been no consensus on indications for surgical intervention . Three cases are presented, which together demonstrate by their diffe rent presentation, clinical course and MRI findings that each patient with a CCH requires an individually tailored management. Presentation, clinical course and accessibility for operation are the factors that determine whether a surgical or a conservative approach should be adop ted.