Propranolol Treatment of Cavernous Malformations with Symptomatic Hemorrhage.

Abstract

BACKGROUND:

Cerebral cavernous malformations are more common than generally thought, affecting approximately 1 in every 250 adults. Most of these lesions are asymptomatic or have a relatively benign course, but a small minority behave aggressively and present with recurrent episodes of symptomatic hemorrhage. A safe and effective medical treatment option for the management of this latter group would be useful. Propranolol has recently been shown to be effective in the treatment of infantile hemangioma, a close pathologic counterpart of cavernous malformations. These results suggest a potential role for propranolol treatment in the management of patients with symptomatic cavernous malformations.

METHODS:

Low-dose propranolol (20 mg, three times daily) was used to treat 2 adult female patients in their mid- to late fifties, both of whom had symptomatic cavernous malformations and a history of repeated hemorrhage. Serial magnetic resonance imaging studies after the initiation of propranolol demonstrated regression of the lesions and no evidence of recurrent hemorrhage.

CONCLUSIONS:

Propranolol may offer a safe and effective treatment for patients who have cavernous malformations with symptomatic hemorrhage. Additional studies are needed to confirm these findings.

• Authors: Joseph M Zabramski, M Yashar S Kalani, Aristotelis S Filippidis, Robert F Spetzler
• Journal: World neurosurgery (World Neurosurg) Vol. 88 Pg. 631-639 (Apr 2016) ISSN: 1878-8769 [Electronic] United States
• PMID: 26578351 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Adrenergic beta-Antagonists
• Propranolol

Topics

• Adrenergic beta-Antagonists (administration & dosage)
• Adult
• Brain Neoplasms (complications, diagnosis, drug therapy)
• Cerebral Hemorrhage (diagnosis, etiology, prevention & control)
• Female
• Hemangioma, Cavernous, Central Nervous System (complications, diagnosis, drug therapy)
• Humans
• Middle Aged
• Propranolol (administration & dosage)
• Treatment Outcome