Propranolol stops progressive multiple cerebral cavernoma in an adult patient

Abstract Objective To report a case of a patient with multiple cerebral cavernous malformations (CCM). Observation A 22 year old man with mild von Willebrand disease presented with two occipital CCM, one of them with acute hemorrhage. Genetic testing for CCM1–3 did not reveal a mutation. Over a peri...

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Bibliographic Details
Published in:Journal of the neurological sciences 2016-08, Vol.367, p.15-17
Main Authors: Reinhard, Matthias, Schuchardt, Florian, Meckel, Stephan, Heinz, Jürgen, Felbor, Ute, Sure, Ulrich, Geisen, Ulrich
Format: Article
Language:English
Subjects:
Brain - diagnostic imaging
Brain - drug effects
Cerebral cavernoma
Disease Progression
Follow-Up Studies
Hemangioma, Cavernous, Central Nervous System - diagnostic imaging
Hemangioma, Cavernous, Central Nervous System - drug therapy
Hemangioma, Cavernous, Central Nervous System - genetics
Hemophilia
Humans
Intracerebral hemorrhage
Male
Neurology
Neuroprotective Agents - therapeutic use
Propranolol
Propranolol - therapeutic use
Thalidomide
Treatment Outcome
Willebrand
Young Adult
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Summary:Abstract Objective To report a case of a patient with multiple cerebral cavernous malformations (CCM). Observation A 22 year old man with mild von Willebrand disease presented with two occipital CCM, one of them with acute hemorrhage. Genetic testing for CCM1–3 did not reveal a mutation. Over a period of 54 months, the patient suffered 26 new CCM hemorrhages despite multiple treatment attempts including thalidomide, simvastatin and hemostatic factors. Only after initiation of propranolol, which has already been successfully used in three children with giant cerebral cavernoma, the occurrence of new CCM with hemorrhages was completely stopped already at dose of 30 mg daily – now for a period of 26 months and without any other medications. Conclusion This case suggests a protective role for propranolol in preventing the occurrence of new cerebral cavernoma with hemorrhages in adults with multiple CCM.
ISSN:0022-510X
1878-5883
DOI:10.1016/j.jns.2016.04.053