Initial Management at Presentation
- Surgery: Surgical excision is an established treatment option after a hemorrhage or seizure. The benefits and risks of surgery should be carefully evaluated.
- Radiosurgery – alternative when surgical risk high: Radiosurgery can be considered as an alternate treatment to surgery, although it is considered unproven. It can be used for deep-seated cavernous malformations, especially those in the brainstem, where the surgical risks are high.
- Rehabilitation for associated injuries: Rehabilitation may be needed for patients with neurological and cognitive deficits.
- Yearly clinical follow-up with imaging: Clinical follow-up with MRI is needed, especially in children, because of the dynamic nature of the disease, such as de novo development.