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[Cavernomas of the central nervous system. Historical data and changing ideas].

Neuro-Chirurgie 2007 June
Since the advent of modern neuroimaging (MRI) cerebral cavernomas are usually diagnosed "in vivo". In this paper we describe the data which improved our knowledge of the disease: 1) nosologically, cerebral cavernomas belong to the group of cerebral vascular hamartomas which can be associated between themselves ("mixed" lesions); 2) hemodynamically, the annual risk of hemorrhage increases after a first bleeding and in deep located lesions (brainstem); 3) association between cavernomas and developmental venous anomalies may be observed; the later on must be left in place at operation; 4) immunocytochemical studies (PCNA) show that cavernomas should be considered more as a benign vascular tumor than as a malformation; 5) familial forms (20%) are characterized by multiple locations and "de novo" lesions; 6) better understanding of the natural history of cavernomas, which is a dynamic lesion, leads to broader surgical indications (no alternative treatment).

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