2016
DOI: 10.1016/s1474-4422(15)00303-8
|View full text |Cite
|
Sign up to set email alerts
|

Clinical course of untreated cerebral cavernous malformations: a meta-analysis of individual patient data

Abstract: SummaryBackgroundCerebral cavernous malformations (CCMs) can cause symptomatic intracranial haemorrhage (ICH), but the estimated risks are imprecise and predictors remain uncertain. We aimed to obtain precise estimates and predictors of the risk of ICH during untreated follow-up in an individual patient data meta-analysis.MethodsWe invited investigators of published cohorts of people aged at least 16 years, identified by a systematic review of Ovid MEDLINE and Embase from inception to April 30, 2015, to provid… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
2
2
1

Citation Types

14
170
2
7

Year Published

2017
2017
2023
2023

Publication Types

Select...
7
1

Relationship

0
8

Authors

Journals

citations
Cited by 269 publications
(193 citation statements)
references
References 28 publications
14
170
2
7
Order By: Relevance
“…We recognize that there are inherent biases in the annual hemorrhage recurrence rate calculation, since the rebleeding rate after a bleed are higher than in incidentally detected BCM [17,18]. In many surgical reports, the annual re-hemorrhage rates have been variable and generally high, ranging from 15 to 60%.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…We recognize that there are inherent biases in the annual hemorrhage recurrence rate calculation, since the rebleeding rate after a bleed are higher than in incidentally detected BCM [17,18]. In many surgical reports, the annual re-hemorrhage rates have been variable and generally high, ranging from 15 to 60%.…”
Section: Discussionmentioning
confidence: 99%
“…Therefore, only patients who were surgically treated were included. In a recent meta-analysis of the natural history of untreated cerebral cavernous malformations, 575 cases of BMC were included [18]. Brain stem location was independently associated with the occurrence of intracranial cerebral hemorrhage (30.8% 5-year risk bleed).…”
Section: Discussionmentioning
confidence: 99%
“…The haemorrhage rate per patient-year has been reported to be significantly lower in incidentally discovered groups when compared to symptomatic groups [Washington et al, 2010;Al-Holou et al, 2012;Al-Shahi Salman et al, 2012;Gross et al, 2016;Horne et al, 2016;Akers et al, 2017]. In a single-centre cohort of 107 individuals with CCM as an incidental finding, the only patient in whom a prospective haemorrhage was definitively related to the cavernous malformation was in fact diagnosed as having a familial form of CCM.…”
Section: Genetic Counselling Current Guidelines and Patient Organizmentioning
confidence: 97%
“…Seizures are the predominant first symptom of supratentorial lobar CCMs, while brainstem lesions are primarily associated with cranial nerve palsy, hemiparesis, and other focal neurological deficits. Prior haemorrhage and brainstem location appear to confer a higher risk for symptomatic haemorrhage, while the annual re-hemorrhage rate has been reported to decline over time [AlHolou et al, 2012;Al-Shahi Salman et al, 2012;Gross et al, 2016;Horne et al, 2016;Gross and Du, 2017].…”
Section: Genetic Counselling Current Guidelines and Patient Organizmentioning
confidence: 99%
“…The principle danger inherent to CCM is the hemorrhage risk that has been estimated around 0.6–2% per lesion-year or 4.3–13% per patient-year in prospective studies with FCCM ( 3 5 ). While no definite evidence is suggested to correlate between hemorrhagic risk and size, age, sex, multiplicity or associated DVA, prior hemorrhage and brainstem CCM location were found to be the only significant risk factors for CCM hemorrhage ( 6 , 7 ). Whereas in other vascular malformations (i.e., aneurysms, arteriovenous malformations) grading systems have been established to estimate the risk of intracerebral hemorrhage (ICH), so far no grading system exists in the literature to serve as a valuable aid in the clinical decision as to whether perform conservative or surgical treatment in patients with CCM ( 8 10 ).…”
Section: Introductionmentioning
confidence: 89%