Brain vascular malformations, including arteriovenous malformations (AVM), cavernous
malformations (CVM) and aneurysms, are a source of life-threatening risk of intracranial
hemorrhage. The etiology and pathogenesis are unknown. There is no medical therapy presently
available. Prevention of spontaneous intracerebral hemorrhage (ICH) is the primary reason to
treat brain vascular malformations. The goal of this study is to: begin pilot studies to lay
the groundwork for future clinical trials to develop medical therapy to decrease ICH risk.
Matrix metalloproteinases (MMPs) regulate the extracellular matrix in association with
various hemorrhagic brain disorders. MMP-9 has been most consistently associated with
vascular wall instability and hemorrhagic brain disorders. Doxycycline, a non-specific MMP
inhibitor, may enhance vascular stability, thus reducing the risk of spontaneous hemorrhage
in brain vascular malformations by decreasing MMP-9 activity.