Antithrombotic therapy of Cerebral cavernous malformations

•Slow-flow vascular malformations (VM) may appear in the central nervous system.•Antithrombotic therapy may be an approach to treat intracerebral venous anomalies.•Conservative treatment may lead to spontaneous resolution of VM. Cavernous malformations are recognized as the most common vascular anomalies in the brain, that often lead to hemorrhage with neurological symptoms. Usually the treatment is surgical removal or stereotactic radiotherapy. We present a case of a slow-flow vascular anomaly located in the cavernous sinus with recurrent partial thrombotic areas. Inspired by treatment of peripheral venous anomalies antithrombotic therapy was initiated instead of surgery or stereotactic radiotherapy. This led to complete spontaneous resolution of the lesion and normalization of symptoms within nine months. The patient never showed any symptoms over a period of eight years while continuing antithrombotic therapy. Based on this case this therapy may be a reasonable approach to treat intracerebral venous anomalies.