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@ARTICLE{Kong:180148,
      author       = {L. Kong and X.-J. Ma$^*$ and X.-Y. Xu and P.-P. Liu and
                      Z.-Y. Wu and L.-W. Zhang and J.-T. Zhang and Z. Wu and L.
                      Wang and D. Li},
      title        = {{F}ive-year symptomatic hemorrhage risk of untreated
                      brainstem cavernous malformations in a prospective cohort.},
      journal      = {Neurosurgical review},
      volume       = {45},
      number       = {4},
      issn         = {0344-5607},
      address      = {New York},
      publisher    = {Springer},
      reportid     = {DKFZ-2022-01135},
      pages        = {2961-2973},
      year         = {2022},
      note         = {2022 Aug;45(4):2961-2973},
      abstract     = {Hemorrhage of brainstem cavernous malformation (CM) would
                      cause various symptoms and severe disability. The study
                      aimed to elaborate on the 5-year actuarial cumulative hazard
                      of symptomatic hemorrhage. Patients diagnosed in our
                      institute between 2009 and 2013 were prospectively
                      registered. All clinical data were obtained, follow-up was
                      performed, and risk factors were evaluated. Four hundred
                      sixty-eight patients (217 female, $46.4\%)$ were included in
                      the study with a median follow-up duration of 79.0 months. A
                      total of 137 prospective hemorrhages occurred in 107
                      patients $(22.9\%)$ during 1854.0 patient-years.
                      Multivariate Cox analysis found age ≥ 55 years (hazard
                      ratio (HR) 2.166, p = 0.002), DVA (HR 1.576, p = 0.026),
                      superficial-seated location (HR 1.530, p = 0.047), and
                      hemorrhage on admission (HR 2.419, p = 0.026) as independent
                      risk factors for hemorrhage. The 5-year cumulative hazard of
                      hemorrhage was $30.8\%$ for the overall cohort, $47.8\%$ for
                      60 patients with age ≥ 55 years, $43.7\%$ for 146 patients
                      with DVA, $37.9\%$ for 272 patients with superficial-seated
                      lesions, and $37.2\%$ for 341 patients with hemorrhage on
                      admission. As a stratified analysis, within subcohort of 341
                      patients with a hemorrhagic presentation, age ≥ 55 years
                      (HR 3.005, p < 0.001), DVA (HR 1.801, p = 0.010), and
                      superficial-seated location (HR 2.276, p = 0.001) remained
                      independently significant. The 5-year cumulative hazard of
                      hemorrhage was $52.0\%$ for 119 patients with both DVA and
                      hemorrhagic presentation. The 5-year cumulative hemorrhagic
                      risk was $30.8\%$ and was higher in subgroups if harboring
                      risk factors that helped to predict potential hemorrhagic
                      candidates and were useful for treatment
                      decision-making.Clinical Trial Registration-URL:
                      http://www.chictr.org.cn Unique identifier:
                      ChiCTR-POC-17011575.},
      keywords     = {Brainstem cavernous malformation (Other) / Cavernoma
                      (Other) / Cerebral cavernous malformation (Other) /
                      Hemorrhage risk (Other) / Natural history (Other)},
      cin          = {A240},
      ddc          = {610},
      cid          = {I:(DE-He78)A240-20160331},
      pnm          = {311 - Zellbiologie und Tumorbiologie (POF4-311)},
      pid          = {G:(DE-HGF)POF4-311},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35633420},
      doi          = {10.1007/s10143-022-01815-2},
      url          = {https://inrepo02.dkfz.de/record/180148},
}