The management of cavernous malformations (CMs) in a child is similar in ma
ny ways to that of CMs in an adult. There are specific general principles t
hat need to be considered when approaching these lesions in children, howev
er. The long life span anticipated in the pediatric patient may favor an ag
gressive surgical approach for single, small asymptomatic cavernous malform
ations or for certain symptomatic lesions in eloquent locations. The observ
ed history of a given malformation may be the best guide to determine its t
reatment. The authors discuss some of these principles and review their exp
erience with a series of children who have presented for management of cere
bral CM.