Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study
Abstract Knowledge of the bleeding risk and the long-term outcome of conservatively treated patients with cavernous malformations (CM) is poor. In this work, we studied the occurrence of CM-associated hemorrhage over a 10-year period and investigated risk factors for bleeding. Our institutional data...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
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Nature Portfolio
2023-09-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-42594-0 |
| _version_ | 1797452621518209024 |
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| author | Alejandro N. Santos Laurèl Rauschenbach Hanah H. Gull Angelina Olbrich Thiemo F. Dinger Marvin Darkwah Oppong Christoph Rieß Bixia Chen Annika Lenkeit Börge Schmidt Yan Li Ramazan Jabbarli Karsten H. Wrede Adrian Siegel Ulrich Sure Philipp Dammann |
| author_facet | Alejandro N. Santos Laurèl Rauschenbach Hanah H. Gull Angelina Olbrich Thiemo F. Dinger Marvin Darkwah Oppong Christoph Rieß Bixia Chen Annika Lenkeit Börge Schmidt Yan Li Ramazan Jabbarli Karsten H. Wrede Adrian Siegel Ulrich Sure Philipp Dammann |
| author_sort | Alejandro N. Santos |
| collection | DOAJ |
| description | Abstract Knowledge of the bleeding risk and the long-term outcome of conservatively treated patients with cavernous malformations (CM) is poor. In this work, we studied the occurrence of CM-associated hemorrhage over a 10-year period and investigated risk factors for bleeding. Our institutional database was screened for patients with cerebral (CCM) or intramedullary spinal cord (ISCM) CM admitted between 2003 and 2021. Patients who underwent surgery and patients without completed follow-up were excluded. Analyses were performed to identify risk factors and to determine the cumulative risk for hemorrhage. A total of 91 CM patients were included. Adjusted multivariate logistic regression analysis identified bleeding at diagnosis (p = 0.039) and CM localization to the spine (p = 0.010) as predictors for (re)hemorrhage. Both risk factors remained independent predictors through Cox regression analysis (p = 0.049; p = 0.016). The cumulative 10-year risk of bleeding was 30% for the whole cohort, 39% for patients with bleeding at diagnosis and 67% for ISCM. During an untreated 10-year follow-up, the probability of hemorrhage increased over time, especially in cases with bleeding at presentation and spinal cord localization. The intensity of such increase may decline throughout time but remains considerably high. These findings may indicate a rather aggressive course in patients with ISCM and may endorse early surgical treatment. |
| first_indexed | 2024-03-09T15:11:17Z |
| format | Article |
| id | doaj.art-ee18c6b245cb41e080263c003d75b6d6 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-09T15:11:17Z |
| publishDate | 2023-09-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-ee18c6b245cb41e080263c003d75b6d62023-11-26T13:24:43ZengNature PortfolioScientific Reports2045-23222023-09-011311710.1038/s41598-023-42594-0Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up studyAlejandro N. Santos0Laurèl Rauschenbach1Hanah H. Gull2Angelina Olbrich3Thiemo F. Dinger4Marvin Darkwah Oppong5Christoph Rieß6Bixia Chen7Annika Lenkeit8Börge Schmidt9Yan Li10Ramazan Jabbarli11Karsten H. Wrede12Adrian Siegel13Ulrich Sure14Philipp Dammann15Department of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenInstitute for Medical Informatics, Biometry and Epidemiology, University Hospital of EssenInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurology, University of ZurichDepartment of Neurosurgery and Spine Surgery, University Hospital EssenDepartment of Neurosurgery and Spine Surgery, University Hospital EssenAbstract Knowledge of the bleeding risk and the long-term outcome of conservatively treated patients with cavernous malformations (CM) is poor. In this work, we studied the occurrence of CM-associated hemorrhage over a 10-year period and investigated risk factors for bleeding. Our institutional database was screened for patients with cerebral (CCM) or intramedullary spinal cord (ISCM) CM admitted between 2003 and 2021. Patients who underwent surgery and patients without completed follow-up were excluded. Analyses were performed to identify risk factors and to determine the cumulative risk for hemorrhage. A total of 91 CM patients were included. Adjusted multivariate logistic regression analysis identified bleeding at diagnosis (p = 0.039) and CM localization to the spine (p = 0.010) as predictors for (re)hemorrhage. Both risk factors remained independent predictors through Cox regression analysis (p = 0.049; p = 0.016). The cumulative 10-year risk of bleeding was 30% for the whole cohort, 39% for patients with bleeding at diagnosis and 67% for ISCM. During an untreated 10-year follow-up, the probability of hemorrhage increased over time, especially in cases with bleeding at presentation and spinal cord localization. The intensity of such increase may decline throughout time but remains considerably high. These findings may indicate a rather aggressive course in patients with ISCM and may endorse early surgical treatment.https://doi.org/10.1038/s41598-023-42594-0 |
| spellingShingle | Alejandro N. Santos Laurèl Rauschenbach Hanah H. Gull Angelina Olbrich Thiemo F. Dinger Marvin Darkwah Oppong Christoph Rieß Bixia Chen Annika Lenkeit Börge Schmidt Yan Li Ramazan Jabbarli Karsten H. Wrede Adrian Siegel Ulrich Sure Philipp Dammann Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study Scientific Reports |
| title | Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study |
| title_full | Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study |
| title_fullStr | Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study |
| title_full_unstemmed | Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study |
| title_short | Natural course of cerebral and spinal cavernous malformations: a complete ten-year follow-up study |
| title_sort | natural course of cerebral and spinal cavernous malformations a complete ten year follow up study |
| url | https://doi.org/10.1038/s41598-023-42594-0 |
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