Cerebral cavernous malformations, or CCMs, are abnormal blood vessels mostly found in the brain. These enlarged vessels gather into clusters about the size of a raspberry. Symptoms may include headaches, loss of balance and seizures. CCMs can sometimes lead to stroke in younger people. CCMs have also been discovered in the skin and eyes.
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ANDREW SOUTHERLAND: CCM stands for Cerebral Cavernous malformations. These are vascular malformations that occur in the brain. In some folks, they can be sporadic, meaning that there's no tendency for them to run in families. In other patients, it can be genetic, meaning that they do run in families. What they are specifically are little malformations of blood vessels in the brain that are not attached to the normal circulation of the brain. Oftentimes, we find them incidentally and we have to keep an eye on them and they don't cause patients many problems. But in other cases, they can be a source for stroke, meaning on the brain or even seizures in folks that have epilepsy related to cavernous malformations.
ZUSEEN RANNIGAN: The primary symptom per say for patients who have CCM is seizures So patients who have seizures sometimes get worked up and then discover that they had CCM. Other than that, there really isn't a warning sign aside from having an actual bleed which may result in severe neurological deficits whether that be facial droop, extremity weakness, that sort of thing.
ANDREW SOUTHERLAND: We will assess the location of the cavernous malformation, we'll try to use some advanced imaging such as MRI based imaging to see if there's been any prior bleeding or swelling around the cavernous malformation that might give us a sense of its risk for future complications. And then we may make a decision ranging from we're just going to keep an eye on it with some monitoring with imaging over time on some sort of regular basis depending on the patient and the patient's family history and genetic profile. We may refer them for genetic counseling.
CHELSEA CHAMBERS: About 80 percent of the time they're sporadic but the 20 percent of the time when they're familial is when I become involved and that means that there could be an underlying genetic reason behind them.
BARRETT ZLOTOFF: What is a dermatologist doing on the CCM team? Because this is a disease of the brain. What we've discovered is that there are lesions in other organs as well. And one of the main places where there are lesions is in the skin. So 30 percent of patients with CCM will have skin lesions.
ANDREW SOUTHERLAND: UVA is the first health system in the Commonwealth of Virginia to be an HMO Licensed Clinical Center for the management of patients with cavernous malformations. And so we are fortunate to have that designation because of the comprehensive approach we take to the management of patients with cavernous malformations.
ZUSEEN RANNIGAN: We have dedicated our practice to wanting to provide the best, safest and most thorough care for CCM patients.
