Cavernous malformations are growths of abnormal blood vessels within the brain. There are many different types of abnormal blood vessels that can exist in the brain, and what distinguishes cavernous malformations, or cav mals, are that they’re usually made up of very low flow, so not high pressure, blood vessels. What this means is that they can sit dormant for a very very long time, and the reason that they’re a problem is that they can bleed and that bleeding can cause pressure on the brain. The sort of chemical irritation bleeding can cause seizures, depending where they’re located in the brain, or they sometimes can grow and get bigger over time, and they can physically cause pressure on the surrounding brain, which can lead to symptoms like headache, weakness, differences in sensation or visual problems. Most cavernous malformations are one time problems, there’s a single one that exists somewhere in the brain or spinal cord, but there are certain familial conditions where they can exist in multiple different spots throughout the brain and spinal cord and in those cases, where we see multiple cavernous malformations, we’ll often help to treat the child with a referral to a geneticist. My job as a neurosurgeon is to look at scans where kids have cavernous malformations, and if we can identify one that is a specific problem causer, something that has bled, something that has been pushing on an important part of the brain, something that we watch over time and we see it getting bigger, I can perform an operation to remove them and take them out. Cavernous malformations are different than other types of blood vessel malformations, in that they are not great candidates to be treated with radiation, at least not in the vast majority of cases, and they’re not things that can be glued or plugged up from the inside with interventional neuroradiology techniques, for example. Most of the time, what I end up doing is talking to families about what a cavernous malformation is, and then counseling them on hopefully, the ability of their child to live a full, normal life and do well with no need for surgery or other treatment. Other times, if we see that they’re in a particular spot, or they look particularly dangerous, based on things that we see on a scan, those are cases where we may talk about doing an operation to try to make it go away.