Learning that you have a cavernous malformation can force you to ask a lot of questions that don’t always have obvious answers. Choosing a doctor who has plenty of experience working with this condition gives you the highest chance of recovering quickly while limiting long-term impairments. If you haven’t chosen a surgeon yet, then you can use this patient’s guide to familiarize yourself with what you can expect before, during and after receiving your treatment.
Surgical Options for Treating Cavernous Malformations
If your cavernous malformation doesn’t cause discomfort or other issues, then your doctor may simply want to monitor the condition by taking regular MRIs of your brain. Many doctors also prescribe medications to prevent seizures, which are fairly common in people with this condition.
Children and young adults with cavernous malformations may undergo sclerotherapy to shrink tumors. This non-invasive procedure involves injecting medication directly into the affected blood vessels. When successful, this treatment causes vessels to shrink and, eventually, dissolve.
Doctors typically rely on two surgical options when treating adults with cavernous malformations. If your malformation is located within the brain, then your doctor will probably want to perform a craniotomy. A craniotomy involves removing a part of the skull so the surgeon has access to the affected area. If the malformation occurs in your spine, then your surgeon will probably encourage you to undergo a laminectomy. This procedure requires removing the back part of the vertebra to reduce pressure on the spinal cord and prevent future symptoms.
There are times when doctors may advise against surgical treatments. If you are over 65 or have an existing health condition, then your doctor may want to minimize the malformation’s effects rather than remove it from your brain or spine.
What to Expect During Surgery
Regardless of whether your surgeon performs a craniotomy or laminectomy, you will receive general anesthesia before the procedure. General anesthesia makes surgery easier for you and the doctor. Since you lose consciousness while under general anesthesia, you shouldn’t experience any pain or fear. Most patients don’t remember anything about their surgeries. Anesthesia also helps ensure that you remain perfectly still during the surgery, which makes it easier for your doctor to perform the operation perfectly.
If your doctor performs a craniotomy, he or she will remove a small part of the skull to gain access to the brain. Advances in surgical technology have made it possible for doctors to remove tumors through small incisions that usually measure no longer than one centimeter. Such a small incision is usually sufficient for removing tumors several inches under the brain’s surface.
If your doctor performs a laminectomy, he or she will remove a small portion of your vertebra. The surgery does not require cutting the muscles. Instead, back muscles are pushed aside to offer better access to the vertebra. In most cases, your surgeon will only remove the back of your vertebra. The rest of the vertebra can remain intact as long as it does not put pressure on the spinal cord.
Both surgeries have high success rates. While they may sound scary, most people recover from the surgeries quickly.
Recovering From Your Surgery
In most cases, you can expect to leave the hospital within two to three days of your surgery. During this time, nurses will make sure incisions heal properly and you remain comfortable. You will also meet with your doctor to determine whether you are recovering normally.
After leaving the hospital, you should avoid strenuous activities for at least one week. Many patients need to rest for two to three weeks before they fully recover. Contact your doctor immediately if you develop new symptoms or pain.
If your cavernous malformation caused cognitive or physical problems before the surgery, then you will most likely need to undergo rehabilitation to regain those skills. Rehab can take anywhere from a few weeks to several months, depending on the deficit and its severity. Physical deficits usually require less rehab than cognitive and neurological problems. Some patients cannot regain lost skills, but rehab can teach them new ways to enjoy full lives.
Managing Your Condition
Many patients who undergo surgery never have future problems with cavernous malformations. Still, your doctor will probably recommend getting an annual MRI to make sure the condition does not return. You may also need to take medications that lower your risk of seizure. Taking medication is often recommended when surgery cannot completely remove the malformation.
Cavernous malformations are usually congenital, meaning that they are present at birth. They may lay dormant for decades before causing you any health issues. Since the condition is congenital, lifestyle changes shouldn’t influence whether the condition reoccurs. Still, it’s a good idea to follow your doctor’s advice so you can prevent related health problems. This may mean eating a balanced diet, avoiding tobacco products and exercising daily.
Nearly all cerebrovascular conditions can have unwanted outcomes, including physical and cognitive impairments. With the right treatment option, though, patients usually recover from malformations after participating in several weeks or months of rehabilitation. Although it’s a frightening situation for many patients, most can return to their lives within a few weeks.
