Atorvastatin Treatment of Cavernous Angiomas With Symptomatic Hemorrhage Exploratory Proof of Concept (AT CASH EPOC) Trial

Inclusion Criteria

• Diagnosis of CCM of any genotype supported by relevant imaging studies.
• Symptomatic CCM bleeding event within 1 year prior to enrollment.
• Must be willing/able to travel to the study site for all study visits (baseline, 12 months, and 24 months) over the course of the study period.

Exclusion Criteria

• Pre-menopausal women who are breastfeeding, pregnant or likely to get pregnant during the study period.
• Previous cranial irradiation or surgical/radiosurgical treatment of CCM lesion.
• Failure to pass MRI safety screening (claustrophobia, metal implant . . . etc)
• Known allergy or intolerance to gadolinium.
• Severely impaired renal function (eGFR < 60ml/min), active renal disease or status post-kidney transplants.
• Statin therapy, for any indication, for more than 7 continuous days or greater than 14 total days within 12 months preceding enrollment.
• Indication to use statin medication for current approved indication, unrelated to CCM
• Known allergy or intolerance to statins
• Liver dysfunction or active liver disease (including chronic viral hepatitis) defined as baseline serum transaminases levels twice the upper range of normal.
• Previous diagnosis of skeletal muscle disorders of any cause (myopathy), or baseline creatine kinase level five times the upper range of normal.
• Currently treated with or likely to need treatment with one or more of prohibited medications listed in the protocol.
• Active drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements.
• Serious illness (requiring systemic treatment and/or hospitalization) until subject either completes therapy or is clinically stable on therapy, in the opinion of the site investigator, for at least 30 days prior to study entry.
• Any other condition that the investigator believes would pose a significant hazard to the subject if the investigational therapy were initiated, including conditions resulting in or precipitating myopathy (e.g. HIV, uncontrolled hypothyroidism).
• In the investigator's opinion, the patient is unstable, and would benefit from a specific intervention rather than treatment with atorvastatin.
• Inability or unwillingness of subject or legal guardian/representative to give written informed consent.
• No documentation of valid healthcare insurance.
• No medical record confirmation of primary care physician.