Invitae Cerebral Cavernous Malformations Panel


Test description

The Invitae Cerebral Cavernous Malformations Panel analyzes three genes that are associated with hereditary vascular cavernous malformations in the brain. These genes were selected based on the available evidence to date to provide appropriate testing for cerebral cavernous malformations (CCM).

Genetic testing of these genes may confirm a diagnosis and help inform treatment and management decisions. Identification of a disease-causing variant would also guide testing and diagnosis of at-risk relatives.

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Primary panel (3 genes)


Cerebral cavernous malformations (CCMs) are abnormal collections of blood capillaries in the brain and spinal cord. These vascular malformations are characterized by reduced elasticity and thin blood vessels that are susceptible to hemorrhage. CCMs are a small subset of cerebral vascular malformations and can be recognized through neuroimaging. More than half of all individuals with CCMs become symptomatic, most frequently exhibiting seizures, headaches, focal neurological deficits, and cerebral hemorrhages. Vascular lesions in the spinal cord and other tissues are rare. Most affected individuals manifest symptoms after their second decade of life. Many individuals with CCM may never experience symptoms, but those who do often see abrupt onset.

Depending on ethnicity, 10%–50% of individuals with CCM present as familial cases with dominant inheritance and variable penetrance. Some sporadic cases may actually be familial but without symptoms seen in individuals who have pathogenic genetic changes. Familial cases tend to have more brain lesions (observable by neuroimaging) and suffer from hemorrhages more than twice as often as sporadic cases and throughout their adult lives.

Pathogenic variants in three genes explain the etiology in approximately 80% of familial CCM cases, with KRIT1 showing the highest clinical yield (approximately 55%), followed by CCM2 (approximately 15%) and PDCD10 (approximately 10%).

CCM is inherited in an autosomal dominant manner.

The onset of symptoms is age-dependent, with variable penetrance.

Cerebral cavernous malformations show a prevalence of 1 in 200 (0.5%). There is a higher prevalence in the Hispanic population.

The Invitae Cerebral Cavernous Malformations panel may be considered for individuals with cerebral hemorrhages, stroke, abrupt onset of chronic headache, or seizures.

Assay and technical information

Invitae is a College of American Pathologists (CAP)-accredited and Clinical Laboratory Improvement Amendments (CLIA)-certified clinical diagnostic laboratory performing full-gene sequencing and deletion/duplication analysis using next-generation sequencing technology (NGS).

Our sequence analysis covers clinically important regions of each gene, including coding exons, +/- 10 base pairs of adjacent intronic sequence, and select noncoding variants. Our assay provides a Q30 quality-adjusted mean coverage depth of 350x (50x minimum, or supplemented with additional analysis). Variants classified as pathogenic or likely pathogenic are confirmed with orthogonal methods, except individual variants that have high quality scores and previously validated in at least ten unrelated samples.

Our analysis detects most intragenic deletions and duplications at single exon resolution. However, in rare situations, single-exon copy number events may not be analyzed due to inherent sequence properties or isolated reduction in data quality. If you are requesting the detection of a specific single-exon copy number variation, please contact Client Services before placing your order.

Gene Transcript reference Sequencing analysis Deletion/Duplication analysis
CCM2 NM_031443.3
KRIT1 NM_194456.1
PDCD10 NM_145860.1