Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study
Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the li...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Gomez-Paz, Santiago [verfasserIn] Maragkos, Georgios A. [verfasserIn] Salem, Mohamed M. [verfasserIn] Ascanio, Luis C. [verfasserIn] Lee, Michelle [verfasserIn] Enriquez-Marulanda, Alejandro [verfasserIn] Orrego-Gonzalez, Eduardo [verfasserIn] Kicielinski, Kimberly [verfasserIn] Moore, Justin M. [verfasserIn] Ogilvy, Christopher S. [verfasserIn] Thomas, Ajith J. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: World neurosurgery - Amsterdam : Elsevier, 2010, 135, Seite e477-e487 |
|---|---|
| Übergeordnetes Werk: |
volume:135 ; pages:e477-e487 |
| DOI / URN: |
10.1016/j.wneu.2019.12.035 |
|---|
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| 520 | |a Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. | ||
| 650 | 4 | |a Cavernoma | |
| 650 | 4 | |a Cavernous hemangioma | |
| 650 | 4 | |a Cavernous malformation | |
| 650 | 4 | |a Cerebrovascular malformations | |
| 650 | 4 | |a Vascular malformation | |
| 700 | 1 | |a Maragkos, Georgios A. |e verfasserin |0 (orcid)0000-0003-2156-7391 |4 aut | |
| 700 | 1 | |a Salem, Mohamed M. |e verfasserin |0 (orcid)0000-0001-7644-2911 |4 aut | |
| 700 | 1 | |a Ascanio, Luis C. |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Michelle |e verfasserin |4 aut | |
| 700 | 1 | |a Enriquez-Marulanda, Alejandro |e verfasserin |0 (orcid)0000-0001-6091-390X |4 aut | |
| 700 | 1 | |a Orrego-Gonzalez, Eduardo |e verfasserin |0 (orcid)0000-0002-8406-4153 |4 aut | |
| 700 | 1 | |a Kicielinski, Kimberly |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Justin M. |e verfasserin |4 aut | |
| 700 | 1 | |a Ogilvy, Christopher S. |e verfasserin |4 aut | |
| 700 | 1 | |a Thomas, Ajith J. |e verfasserin |4 aut | |
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10.1016/j.wneu.2019.12.035 doi (DE-627)ELV003743136 (ELSEVIER)S1878-8750(19)33063-3 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Gomez-Paz, Santiago verfasserin (orcid)0000-0003-2283-3612 aut Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. Cavernoma Cavernous hemangioma Cavernous malformation Cerebrovascular malformations Vascular malformation Maragkos, Georgios A. verfasserin (orcid)0000-0003-2156-7391 aut Salem, Mohamed M. verfasserin (orcid)0000-0001-7644-2911 aut Ascanio, Luis C. verfasserin aut Lee, Michelle verfasserin aut Enriquez-Marulanda, Alejandro verfasserin (orcid)0000-0001-6091-390X aut Orrego-Gonzalez, Eduardo verfasserin (orcid)0000-0002-8406-4153 aut Kicielinski, Kimberly verfasserin aut Moore, Justin M. verfasserin aut Ogilvy, Christopher S. verfasserin aut Thomas, Ajith J. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 135, Seite e477-e487 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:135 pages:e477-e487 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie VZ AR 135 e477-e487 |
| spelling |
10.1016/j.wneu.2019.12.035 doi (DE-627)ELV003743136 (ELSEVIER)S1878-8750(19)33063-3 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Gomez-Paz, Santiago verfasserin (orcid)0000-0003-2283-3612 aut Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. Cavernoma Cavernous hemangioma Cavernous malformation Cerebrovascular malformations Vascular malformation Maragkos, Georgios A. verfasserin (orcid)0000-0003-2156-7391 aut Salem, Mohamed M. verfasserin (orcid)0000-0001-7644-2911 aut Ascanio, Luis C. verfasserin aut Lee, Michelle verfasserin aut Enriquez-Marulanda, Alejandro verfasserin (orcid)0000-0001-6091-390X aut Orrego-Gonzalez, Eduardo verfasserin (orcid)0000-0002-8406-4153 aut Kicielinski, Kimberly verfasserin aut Moore, Justin M. verfasserin aut Ogilvy, Christopher S. verfasserin aut Thomas, Ajith J. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 135, Seite e477-e487 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:135 pages:e477-e487 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie VZ AR 135 e477-e487 |
| allfields_unstemmed |
10.1016/j.wneu.2019.12.035 doi (DE-627)ELV003743136 (ELSEVIER)S1878-8750(19)33063-3 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Gomez-Paz, Santiago verfasserin (orcid)0000-0003-2283-3612 aut Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. Cavernoma Cavernous hemangioma Cavernous malformation Cerebrovascular malformations Vascular malformation Maragkos, Georgios A. verfasserin (orcid)0000-0003-2156-7391 aut Salem, Mohamed M. verfasserin (orcid)0000-0001-7644-2911 aut Ascanio, Luis C. verfasserin aut Lee, Michelle verfasserin aut Enriquez-Marulanda, Alejandro verfasserin (orcid)0000-0001-6091-390X aut Orrego-Gonzalez, Eduardo verfasserin (orcid)0000-0002-8406-4153 aut Kicielinski, Kimberly verfasserin aut Moore, Justin M. verfasserin aut Ogilvy, Christopher S. verfasserin aut Thomas, Ajith J. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 135, Seite e477-e487 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:135 pages:e477-e487 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie VZ AR 135 e477-e487 |
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10.1016/j.wneu.2019.12.035 doi (DE-627)ELV003743136 (ELSEVIER)S1878-8750(19)33063-3 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Gomez-Paz, Santiago verfasserin (orcid)0000-0003-2283-3612 aut Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. Cavernoma Cavernous hemangioma Cavernous malformation Cerebrovascular malformations Vascular malformation Maragkos, Georgios A. verfasserin (orcid)0000-0003-2156-7391 aut Salem, Mohamed M. verfasserin (orcid)0000-0001-7644-2911 aut Ascanio, Luis C. verfasserin aut Lee, Michelle verfasserin aut Enriquez-Marulanda, Alejandro verfasserin (orcid)0000-0001-6091-390X aut Orrego-Gonzalez, Eduardo verfasserin (orcid)0000-0002-8406-4153 aut Kicielinski, Kimberly verfasserin aut Moore, Justin M. verfasserin aut Ogilvy, Christopher S. verfasserin aut Thomas, Ajith J. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 135, Seite e477-e487 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:135 pages:e477-e487 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie VZ AR 135 e477-e487 |
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10.1016/j.wneu.2019.12.035 doi (DE-627)ELV003743136 (ELSEVIER)S1878-8750(19)33063-3 DE-627 ger DE-627 rda eng 610 VZ 44.90 bkl Gomez-Paz, Santiago verfasserin (orcid)0000-0003-2283-3612 aut Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study 2019 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. Cavernoma Cavernous hemangioma Cavernous malformation Cerebrovascular malformations Vascular malformation Maragkos, Georgios A. verfasserin (orcid)0000-0003-2156-7391 aut Salem, Mohamed M. verfasserin (orcid)0000-0001-7644-2911 aut Ascanio, Luis C. verfasserin aut Lee, Michelle verfasserin aut Enriquez-Marulanda, Alejandro verfasserin (orcid)0000-0001-6091-390X aut Orrego-Gonzalez, Eduardo verfasserin (orcid)0000-0002-8406-4153 aut Kicielinski, Kimberly verfasserin aut Moore, Justin M. verfasserin aut Ogilvy, Christopher S. verfasserin aut Thomas, Ajith J. verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 135, Seite e477-e487 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:135 pages:e477-e487 GBV_USEFLAG_U GBV_ELV SYSFLAG_U GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie VZ AR 135 e477-e487 |
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Enthalten in World neurosurgery 135, Seite e477-e487 volume:135 pages:e477-e487 |
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Gomez-Paz, Santiago @@aut@@ Maragkos, Georgios A. @@aut@@ Salem, Mohamed M. @@aut@@ Ascanio, Luis C. @@aut@@ Lee, Michelle @@aut@@ Enriquez-Marulanda, Alejandro @@aut@@ Orrego-Gonzalez, Eduardo @@aut@@ Kicielinski, Kimberly @@aut@@ Moore, Justin M. @@aut@@ Ogilvy, Christopher S. @@aut@@ Thomas, Ajith J. @@aut@@ |
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2019-01-01T00:00:00Z |
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Gomez-Paz, Santiago |
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Gomez-Paz, Santiago ddc 610 bkl 44.90 misc Cavernoma misc Cavernous hemangioma misc Cavernous malformation misc Cerebrovascular malformations misc Vascular malformation Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study |
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610 VZ 44.90 bkl Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study Cavernoma Cavernous hemangioma Cavernous malformation Cerebrovascular malformations Vascular malformation |
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Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study |
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Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study |
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Gomez-Paz, Santiago Maragkos, Georgios A. Salem, Mohamed M. Ascanio, Luis C. Lee, Michelle Enriquez-Marulanda, Alejandro Orrego-Gonzalez, Eduardo Kicielinski, Kimberly Moore, Justin M. Ogilvy, Christopher S. Thomas, Ajith J. |
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symptomatic hemorrhage from cerebral cavernous malformations: evidence from a cohort study |
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Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study |
| abstract |
Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. |
| abstractGer |
Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. |
| abstract_unstemmed |
Objective: Patients with a cerebral cavernous malformation (CCM) can have intracranial hemorrhages ranging from insignificant and chronic microbleeds to life-threatening hemorrhage. Management decisions and patient counseling are based on a heterogeneous body of evidence. We sought to improve the literature by providing our results based on the standardized definitions and aimed to delineate differences in the symptomatic burden for CCMs, based on their anatomic location and presence of developmental venous anomalies. This evidence will aid in clinical decision making and patient counseling.Methods: A retrospective cohort analysis between 1990 and 2018 was performed, including patients with a diagnosis of a CCM. The primary outcome was acute symptomatic hemorrhages.Results: We identified 438 patients harboring 632 CCMs. Mean age at diagnosis was 50 years (standard deviation ±17 years). Median follow-up was 26 months (interquartile range, 7–72 hours). Multiple lesions were encountered in 64 patients (15%). An initial symptomatic presentation was observed in 64% of the patients. There were 438 supratentorial lesions (69%) and 194 infratentorial lesions (31%). A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). A linear mixed-effects regression model showed a significant difference in developing a symptomatic hemorrhage at diagnosis or follow-up between CCMs with an infratentorial location and those with a supratentorial location (odds ratio, 1.81; 95% confidence interval, 1.17–2.81; P = 0.008).Conclusions: Infratentorial cavernous malformations are more likely to present with symptomatic hemorrhages at diagnosis or during follow-up when accounting for size differences between lesions. |
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Symptomatic Hemorrhage From Cerebral Cavernous Malformations: Evidence from a Cohort Study |
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Maragkos, Georgios A. Salem, Mohamed M. Ascanio, Luis C. Lee, Michelle Enriquez-Marulanda, Alejandro Orrego-Gonzalez, Eduardo Kicielinski, Kimberly Moore, Justin M. Ogilvy, Christopher S. Thomas, Ajith J. |
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A symptomatic hemorrhage was observed in 25% of the supratentorial lesions and 29% of the infratentorial lesions (P < 0.001). 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malformation</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Maragkos, Georgios A.</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0003-2156-7391</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Salem, Mohamed M.</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0001-7644-2911</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Ascanio, Luis C.</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Lee, Michelle</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Enriquez-Marulanda, Alejandro</subfield><subfield code="e">verfasserin</subfield><subfield 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