Abstract
Background: Brainstem cavernous malformations (BSCMs) are a subset of cerebral cavernous malformations with precarious locations and potentially devastating clinical courses. The effects and outcomes of treating BSCMs by microsurgery or gamma knife radiosurgery (GKRS) vary across studies.Methods: We searched the Medline, Web of Science, The Cochrane Library, PubMed, and China Biology Medicine disc databases for original articles published in peer-reviewed journals of cohort studies reporting on 20 or more patients of any age with BSCMs with at least 80% completeness of follow-up.Results: We included 43 cohorts involving 2,492 patients. Both microsurgery (RR = 0.04, 95% CI 0.01–0.16, P < 0.01) and GKRS (RR = 0.11, 95% CI 0.08–0.16, P < 0.01) demonstrated great efficacy in reducing the rehemorrhage rate after treatment for BSCMs. The incidence rates of composite outcomes were 19.8 (95% CI 16.8–22.8) and 15.7 (95% CI 11.7–19.6) after neurosurgery and radiosurgery, respectively. In addition, we found statistically significant differences in the median numbers of patients between neurosurgical and radiosurgical cohorts in terms of symptomatic intracranial hemorrhage (ICH; neurosurgical cohorts: median 0, range 0–33; radiosurgical cohorts: median 4, range 1–14; P < 0.05) and persistent focal neurological deficit (FND; neurosurgical cohorts: median 5, range 0–140; radiosurgical cohorts: median 1, range 0–3; P < 0.05).Conclusions: The reported effects of treating BSCMs by microsurgery or GKRS are favorable for reducing recurrent hemorrhage from BSCMs. Patients in the neurosurgery cohort had a lower incidence of symptomatic ICH, while patients in the radiosurgical cohort had a lower incidence of persistent FND.
Highlights
Cerebral cavernous malformations (CCMs) are low-flow vascular abnormalities of the brain that are composed of clusters of dilated, thin-walled capillaries filled with hemosiderin deposits
Eight cohorts involving 370 patients were included in reports on gamma knife radiosurgery (GKRS), and 2,122 patients in 35 cohorts were included in reports on neurosurgery
Brainstem cavernous malformations are a major cause of brainstem hemorrhage, especially if they are not accompanied by coma
Summary
Cerebral cavernous malformations (CCMs) are low-flow vascular abnormalities of the brain that are composed of clusters of dilated, thin-walled capillaries filled with hemosiderin deposits. These lesions have an incidence in the range of 0.4% to 0.8% in the general population [1]. Brainstem cavernous malformations (BSCMs), which are subsets of CCMs, are rare lesions and account for 20% of all CCMs [2]. Hemorrhage ictus can lead to acute deterioration of neurological function and can induce severe symptoms. Brainstem cavernous malformations (BSCMs) are a subset of cerebral cavernous malformations with precarious locations and potentially devastating clinical courses. The effects and outcomes of treating BSCMs by microsurgery or gamma knife radiosurgery (GKRS) vary across studies
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
