A cavernous malformation is a type of rarely-occurring vascular malformation. Vascular malformations are abnormalities in how the blood vessels are formed. Individuals can have a cavernous malformation in any portion of the body, and when it occurs in any area besides the brain or spinal cord, it doesn't tend to cause problems. However, a cavernous malformation can lead to potentially life-threatening complications when it affects the central nervous system. When the formation occurs inside the brain, medical practitioners refer to it as a cerebral cavernous malformation, which is made up of a group of capillaries with thinner and less elastic walls than normal capillaries. These are prone to leaking, which can lead to small pockets of blood inside the brain, resulting in serious and potentially life-threatening neurological consequences.
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Issues With Speech
A cavernous malformation will sometimes exist without ever causing any symptoms. Many individuals might have one in a part of their body and be unaware of it. However, when the cavernous malformation occurs in the brain and causes hemorrhaging, it can lead to issues with speech. The exact kinds of problems vary widely, since this largely depends on where the malformation is located, where the pockets of blood are located, and how much bleeding has occurred. Some patients might experience only mild speech impairment, while others may experience debilitating effects on their ability to communicate. Speech disorders are disorders affecting an individual's ability to create sounds and form language. Patients might experience apraxia, which occurs when parts of the brain required for speaking become damaged. Speech disorders might not be a sign of impaired intelligence or cognition. In fact, many patients with speech disorders know exactly what they want to communicate, and the inability to do so can be frustrating and lead to depression.
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Vision changes can also occur in cerebral cavernous malformation patients. These might occur alongside speech difficulties or other sensory issues. The changes in vision are typically related to a hemorrhage in the sensory processing portion of the brain. How they present varies widely, since the position and effects of every cerebral cavernous malformation are different. The brain may have trouble interpreting the data being sent through the optic nerve. There might also be interrupted connections between the brain and the optic nerve. Changes in vision might be gradual, especially if the bleeding occurs over a long period. A patient might notice their peripheral vision dimming, they may struggle to perceive shadows and shapes, or they might have skewed depth perception. The changes in vision might also be more typical-seeming ones like blurriness that needs correction with eyeglasses. If individuals are experiencing vision changes that aren't helped by glasses, it's best to see an ophthalmologist. They'll be able to determine whether the cause is in the patient's eyes or if it's neurological.
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Weakness And Numbness
A cerebral cavernous malformation might cause numbness and weakness in various places throughout the body. Again, the exact presentation of these symptoms will vary from case to case. It may be difficult to diagnose the cause of the numbness and weakness at first, since these are diffuse symptoms that can be caused by hundreds of different neurological or musculoskeletal conditions. This is further complicated by the slow onset symptoms often have. Since the bleeding into the brain happens slowly, patients might not experience the instantaneous feelings of numbness that occur following a more serious stroke. The muscle weakness might go unnoticed for a while, depending on what muscle groups are affected. If the muscles controlling speech become numb or weak, this can contribute to speech difficulties that are also caused by the cavernous malformation. Patients might also experience progressive difficulty with walking or mobility. If the hands are affected, it might be difficult to engage in hobbies like painting, knitting, crocheting, woodworking, or anything else requiring intricate movements.
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Unsteadiness is another neurological symptom that may occur due to a cerebral cavernous malformation. Like many of the other potential and diffuse neurological symptoms, unsteadiness is also extremely difficult to diagnose. In fact, if it occurs over time rather than spontaneously, many individuals may not be aware it's a symptom. Even when they do become aware they have balance problems or feel unsteady when they walk, they might struggle to remember when it began or how it progressed. This incomplete knowledge can make seeking a diagnosis even harder. Unsteadiness can increase an individual's potential risks for injury. There's a significantly higher chance of falling if individuals struggle to keep their balance. Elderly patients with a cerebral cavernous malformation are in danger of breaking bones or incurring other serious injuries due to a loss of balance. It can also be difficult for elderly patients to get diagnosed, since many of the neurological symptoms are often played off as simply part of getting older. Unsteadiness that comes on all at once should be evaluated by a doctor immediately.
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Seizures are another neurological symptom that can indicate a cavernous malformation. While the most noticeable seizures are often clear signs of a medical emergency, certain types of seizures can go unnoticed. Seizure activity occurs when the brain sets off abnormal electrical impulses, which can occur as a result of accumulating pockets of blood or a more heavy bleed. Generalized seizures are seizures that occur when both hemispheres of the brain experience abnormal activity. Focal seizures occur when only a certain portion of the brain is affected. The most recognizable type of seizure is a generalized tonic-clonic seizure, formerly called a grand mal. During a tonic-clonic seizure, the patient loses consciousness, experiences stiffening of the muscles, and falls to the ground with spastic and jerking movements. A typical tonic-clonic seizure lasts between one and three minutes. If individuals don't have a diagnosed seizure disorder, a seizure is always a medical emergency.