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Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation:a multi-institutional,retrospective study

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Stroke & Vascular Neurology 2024年第3期9卷 221-229,I0130,I0131页

作者： Chloe Dumot Georgios mantziaris Sam Dayawansa Zhiyuan Xu Stylianos Pikis Selcuk Peker Yavuz Samanci Gokce D Ardor ahmed m Nabeel Wael A Reda Sameh R Tawadros Khaled Abdelkarim Amr m N El-Shehaby reem m emad eldin.ahmed h elazzazi Nuria martínez moreno Roberto martínezÁlvarez Roman Liscak Jaromir may David mathieu Jean-Nicolas Tourigny manjul Tripathi Akshay Rajput Narendra Kumar Rupinder Kaur Piero Picozzi Andrea Franzini herwin Speckter Wenceslao hernandez Anderson Brito Ronald E Warnick Juan Alzate Douglas Kondziolka Greg N Bowden Samir Patel Jason Sheehan Department of Neurological Surgery Hospices Civils de LyonLyonFrance Department of Neurological Surgery University of VirginiaCharlottesvilleVirginiaUSA Department of Neurosurgery Koc University School of MedicineIstanbulTurkey Gamma-knife Center Nasser institute HospitalCairoEgypt Neurosurgery Department Benha UniversityBenhaEgypt Departments of Neurosurgery Ain Shams UniversityCairoEgypt Department of Clinical Oncology Ain Shams UniversityCairoEgypt Department of Radiation Oncology National Cancer InstituteCairo UniversityGizaEgypt Faculty of medicine Extended Modular ProgramAin Shams UniversityCairoEgypt Department of Radiosurgery Rúber Internacional HospitalMadridSpain Department of Stereotactic and Radiation Neurosurgery Na Homolce HospitalPragueCzech Republic Neurosurgery Centre de recherche du CHUSUniversitéde SherbrookeSherbrookeQuebecCanada Neurosurgery PGIMERChandigarhChandigarhIndia Radiation Therapy PGIMERChandigarhChandigarhIndia Neurosurgery IRCCS Istituto Clinico HumanitasRozzanoMilanItaly Dominican Gamma Knife Center and Radiology Department CEDIMATSanto DomingoDominican Republic Gamma Knife Center Mayfield ClinicThe Jewish Hospital-Mercy HealthCincinnatiOhioUSA Neurosurgery NYU Langone HealthNew YorkNew YorkUSA Neurosurgery University of AlbertaEdmontonAlbertaCanada Division of Radiation Oncology Department of OncologyUniversity of AlbertaEdmontonAlbertaCanada

Background Cerebral cavernous malformations(CCms)frequently manifest with *** radiosurgery(SRS)has been employed for CCm not suitable for *** effect on reducing haemorrhage risk is still *** aim of this study was to expand on the safety and efficacy of SRS for haemorrhagic *** This retrospective multicentric study included CCm with at least one haemorrhage treated with single-session *** annual haemorrhagic rate(AhR)was calculated before and after *** event analysis and Cox regression were used to evaluate factors associated with *** radiation effects(AREs)and occurrence of new neurological deficits were *** The study included 381 patients (median age:37.5 years(Q1–Q3:25.8–51.9))with 414 *** AhR from diagnosis to SRS excluding the first haemorrhage was 11.08 per 100 CCm-years and was reduced to 2.7 per 100 CCm-years after *** recurrent event analysis,SRS,hR 0.27(95%CI 0.17 to 0.44),ph a decreased risk of haemorrhage,and the presence of developmental venous anomaly(DVA)with an increased risk,hR 1.60(95%CI 1.07 to 2.40),p=*** cumulative risk of first haemorrhage after SRS was 9.4%(95%CI 6%to 12.6%)at 5 years and 15.6%(95%CI%9 to 21.8%)at 10 *** doses>13 Gy,hR 2.27(95%CI 1.20 to 4.32),p=0.012 and the presence of DVA,hR 2.08(95%CI 1.00 to 4.31),p=0.049 were factors associated with higher probability of post-SRS ***-SRS haemorrhage was symptomatic in 22 out of 381(5.8%)patients,presenting with transient(15/381)or permanent(7/381)neurological *** occurred in 11.1%(46/414)CCm and was responsible for transient neurological deficit in 3.9%(15/381)of the patients and permanent deficit in 1.1%(4/381)of the *** doses>13 Gy and CCm volume>0.7 cc were associated with increased risk of ARE.

关键词： doses haemorrhagic diagnosis

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