Cavernomas A Randomised Effectiveness (CARE) pilot trial, to address the effectiveness of active treatment (with neurosurgery or stereotactic radiosurgery) versus conservative management in people with symptomatic brain cavernoma

Addressing priority 1NIHR research in progress

In standard practice in the UK, about one fifth of people with cavernomas have 'active treatment' with either brain surgery to remove a cavernoma or stereotactic radiosurgery to treat it with radiation. These treatments themselves can cause death, disability, and handicap. The pros and cons of active treatment or avoiding it by just treating the symptoms (also known as 'conservative management') are finely balanced. The most reliable way of finding out which management is best is to do a randomised trial, in which suitable patients are allocated to active treatment or conservative management at random. This has never been done with cavernomas.  This pilot study aims to find out whether enough patients can be found for a randomised trial comparing 'active treatment' with 'conservative management' of symptomatic cavernomas.