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024 7 _ |a 1437-2320
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037 _ _ |a DKFZ-2022-01135
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Kong, Lu
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245 _ _ |a Five-year symptomatic hemorrhage risk of untreated brainstem cavernous malformations in a prospective cohort.
260 _ _ |a New York
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336 7 _ |a article
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500 _ _ |a 2022 Aug;45(4):2961-2973
520 _ _ |a 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.
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650 _ 7 |a Brainstem cavernous malformation
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650 _ 7 |a Cavernoma
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650 _ 7 |a Cerebral cavernous malformation
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650 _ 7 |a Hemorrhage risk
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650 _ 7 |a Natural history
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700 1 _ |a Ma, Xiu-Jian
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700 1 _ |a Xu, Xiao-Ying
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700 1 _ |a Liu, Pan-Pan
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700 1 _ |a Wu, Ze-Yu
|b 4
700 1 _ |a Zhang, Li-Wei
|b 5
700 1 _ |a Zhang, Jun-Ting
|b 6
700 1 _ |a Wu, Zhen
|b 7
700 1 _ |a Wang, Liang
|b 8
700 1 _ |a Li, Da
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773 _ _ |a 10.1007/s10143-022-01815-2
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910 1 _ |a Deutsches Krebsforschungszentrum
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