Could propranolol be beneficial in adult cerebral cavernous malformations?

Neurosurg Rev. 2019 Jun;42(2):403-408. doi: 10.1007/s10143-018-01074-0. Epub 2019 Jan 4.

Abstract

Surgery is the only therapeutic option for cerebral cavernous malformations (CCM) and is proposed, whenever possible, after haemorrhagic events, neurological symptoms, or epilepsy, radiosurgery being a controversial alternative in some cases. However, there is no treatment for non-accessible lesions, such as brainstem CCM, multiple CCM, or those located in functional areas. Propranolol, a non-selective beta-blocker used as first-line treatment for infantile haemangiomas, has proved spectacularly effective in a few cases of adult patients with CCM. We herein review the histological, in vitro data and clinical findings that support the idea of propranolol as a potential treatment for CCM. Since one retrospective study has not been conclusive, we support the idea that prospective trials are necessary.

Keywords: Beta-blocker; Cavernomas; Cavernous angiomas; Cavernous haemangiomas; Cavernous malformations.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use*
  • Brain Neoplasms / complications
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / drug therapy*
  • Cardiovascular Agents / therapeutic use*
  • Hemangioma, Cavernous, Central Nervous System / complications
  • Hemangioma, Cavernous, Central Nervous System / diagnostic imaging
  • Hemangioma, Cavernous, Central Nervous System / drug therapy*
  • Hemangioma, Cavernous, Central Nervous System / surgery
  • Humans
  • Propranolol / therapeutic use*

Substances

  • Adrenergic beta-Antagonists
  • Cardiovascular Agents
  • Propranolol