Treatment and Management of CCM

At the University of Chicago Medicine, our neurovascular care team specializes in developing comprehensive surgical and non-surgical management plans for CCM.

When possible, our experts use medication to manage CCM, closely monitoring lesions and symptoms to assess effectiveness. Medication is commonly used to treat or manage certain symptoms, such as headaches and seizures. However, certain indications may warrant surgery. MRI scans may be repeated to help assess the management strategy.

Expert Care for Seizures Associated with CCM

Adults and children who have seizures associated with CCM can also benefit from the leading expertise of neurologists in our two nationally classified Level 4 epilepsy centers: the Comprehensive Epilepsy Center at the University of Chicago Medicine and the Pediatric Epilepsy Center at the University of Chicago Medicine Comer Children's Hospital.

Surgical Management Options for CCM Lesions

When medication is not effective, our integrated physician team offers traditional and minimally invasive surgical management options, including neurointerventional techniques.

Surgery is considered when a lesion has bled, including lesions located in vulnerable areas of the brain. Some lesions are deemed inoperable, because of surgical risks in certain areas of the brain. Our leading expert, Issam A. Awad, MD, has extensive experience with successful surgeries in the most critical areas of the brain. He uses several advanced surgical adjuncts, such as functional MRI, intraoperative brain mapping and image guidance to enhance the safety and effectiveness of those procedures.

Surgery may be recommended when a lesion is located in an area where it can safely be removed and:

  • Recent bleeding is detected.
  • The lesion is growing.
  • Certain types of seizure activity occurs.
  • Symptoms are disabling and cannot be managed with medication.
  • Consequences of hemorrhage outweigh the risks of surgery, including lesions in the brain stem and spinal cord that have already bled and caused disabling symptoms.

Types of Surgery for CCM

Whenever possible, our skilled neurosurgeons at the University of Chicago Medicine perform minimally invasive surgical techniques that offer fewer risks and shorter recovery times than traditional procedures. With image-guided surgical navigation, our experts are able to safely perform microsurgical techniques to remove CCM lesions from the brain or spinal cord with minimal damage to surrounding tissue.

Craniotomy, a procedure performed under general anesthesia, involves opening the skull with image guidance and expert precision to surgically remove the CCM lesion.

Laminectomy is a surgical procedure that requires removing part of the vertebral bone (the lamina) to remove a CCM lesion from the spinal cord. Whenever possible, our neurosurgeons perform minimally invasive laminectomy.

Evidence-Based CCM Care Guidelines

University of Chicago physicians partnered with other internationally known CCM experts to compile comprehensive evidence-based CCM care guidelines (PDF) for the Angioma Alliance, a patient-directed network dedicated to improving the lives of those affected by cavernous angioma.