Vim & Vigor - Fall 2019 - UVA - 53

UVA Investigational
Treatment Study

An Ideal
World

A UVA brain surgeon's quest
to easily treat a common
cause of stroke in the young
BY KELLY CASEY

s a neurosurgeon, Yashar Kalani, MD, PhD, loves
to be able to improve a person's life by operating
on the brain. But for one serious brain disorder, he
hopes to bring about a time when he never has to
don scrubs. "Cerebral cavernous malformation (CCM) is one
of the most common causes of stroke in the young. It's a terrible thing," he says. It's also a condition that, when deep in
the brain, can be a risky surgery.
"In an ideal world, you take a pill and you forget about it,"
Dr. Kalani says.
By building a strong clinical and research team around CCM,
UVA is getting closer to this ideal world. UVA has been designated by the Angioma Alliance as a clinical center for providing
high-quality interdisciplinary care for patients with CCM. This
is Virginia's first and only CCM Clinical Center.

More Common Than You Think

PHOTO BY GETTY IMAGES

Also known as cavernous angiomas, CCMs are clusters of
abnormally dilated blood vessels in the brain or spinal cord.
Although considered to be rare, CCM is quite common,
affecting as many as 1 in 200 to 500 people. Very often, CCM
doesn't cause any problems. But surgery can be essential
when CCM is the reason for a patient's seizures, neurological
deficits or hemorrhagic stroke (caused by a ruptured rather
than blocked blood vessel).

Finding Alternatives to Surgery

"My goal when I came to UVA in 2017 was to make UVA a
prominent center of cerebral vascular excellence," says
Dr. Kalani, who also serves as director of Skull Base Surgery
at UVA. "A big piece of the center is not just surgery and

neurological screening, but researching medical therapy to
deal with this disease as a chronic disease as opposed to a
horrible cause of acute stroke."
This year, Dr. Kalani plans to open a phase 2 clinical trial
testing a blood pressure medication's effectiveness at shrinking
dilated blood vessels in the brain. The drug, propranolol, is
being used off-label to keep CCMs from bleeding, but its effectiveness has yet to be proved in a blinded fashion. Because the
drug has its share of side effects, Dr. Kalani is "super excited"
about another therapy that he's researching in the lab. With
a grant from the Charlottesville-based Focused Ultrasound
Foundation, he is testing a Food and Drug Administrationapproved brain tumor drug, known as 5-ALA, which pools
inside the defective blood vessels. "We then excite this drug
with sound waves so it starts releasing energy and clots off
the cavernous angiomas from the inside." ■
WEBSITE

Meet the Brain Vessel Experts
UVA has a strong team of experts dedicated to treating
a major cause of stroke in the young-abnormal blood
vessel clusters. Learn more about this condition and its
experts at uvahealth.com/cavernoma.

FALL 2019

http://www.uvahealth.com/cavernoma

Vim & Vigor - Fall 2019 - UVA

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