Abstract： Objective To summarize the clinical features,imaging features and treatment principles of intracranial cavernous malformations ( CMs),and provide evidence for effective treatment of intracranial CMs.Methods Clinical data of 127 patients with intracranial CMs treated by microsurgical resection from September 2005 to September 2011 were retrospectively analyzed.Results There were 63 males and 64 females included in 127 patients aged 8 to 62 years.A total of 139 lesions were found with 133 intra - axial ( 103 supratentorial lesions and 30 infratentorial lesions) and 6 extra - axial lesions ( all located in left cavernous sinus ).Epilepsy was the most common clinical symptom; other symptoms included headache and impairment of cranial nerves."mulberry - like" appearance was the typical features of intra - axial lesions in MRI,while extra - axial lesions had different features.All patients received microsurgical treatment.All but five giant lesions were totally removed.One patient suffered post - operative mild hemiparesis.Four patients with pre - operative epilepsy still need anti - epileptic treatment,but no post - operative seizures were found.Conclusions Intra - axial CMs,mainly supratentorial,are the most common type of intracranial CM.Surgical treatment,the first treatment choice,can get good results.Extra -axial CMs are a rare type of intracranial CM that mainly locates in cavernous sinus.Both surgical resection and radiosurgery can get satisfactory results.