Cavernous malformations of the central nervous system: An international consensus statement.
Cavernous malformation
Consensus
Deep-seated
Developmental venous anomaly
Stereotactic radiosurgery
Surgery
Journal
Brain & spine
ISSN: 2772-5294
Titre abrégé: Brain Spine
Pays: Netherlands
ID NLM: 9918470888906676
Informations de publication
Date de publication:
2023
2023
Historique:
received:
14
06
2023
revised:
19
10
2023
accepted:
04
11
2023
medline:
29
11
2023
pubmed:
29
11
2023
entrez:
29
11
2023
Statut:
epublish
Résumé
Cavernous malformations (CM) of the central nervous system constitute rare vascular lesions. They are usually asymptomatic, which has allowed their management to become quite debatable. Even when they become symptomatic their optimal mode and timing of treatment remains controversial. A consensus may navigate neurosurgeons through the decision-making process of selecting the optimal treatment for asymptomatic and symptomatic CMs. A 17-item questionnaire was developed to address controversial issues in relation to aspects of the treatment, surgical planning, optimal surgical strategy for specific age groups, the role of stereotactic radiosurgery, as well as a follow-up pattern. Consequently, a three-stage Delphi process was ran through 19 invited experts with the goal of reaching a consensus. The agreement rate for reaching a consensus was set at 70%. A consensus for surgical intervention was reached on the importance of the patient's age, symptomatology, and hemorrhagic recurrence; and the CM's location and size. The employment of advanced MRI techniques is considered of value for surgical planning. Observation for asymptomatic eloquent or deep-seated CMs represents the commonest practice among our panel. Surgical resection is considered when a deep-seated CM becomes symptomatic or after a second bleeding episode. Asymptomatic, image-proven hemorrhages constituted no indication for surgical resection for our panelists. Consensus was also reached on not resecting any developmental venous anomalies, and on resecting the associated hemosiderin rim only in epilepsy cases. Our Delphi consensus provides an expert common practice for specific controversial issues of CM patient management.
Identifiants
pubmed: 38020995
doi: 10.1016/j.bas.2023.102707
pii: S2772-5294(23)00995-5
pmc: PMC10668094
doi:
Types de publication
Journal Article
Langues
eng
Pagination
102707Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Acta Neurochir Suppl. 1997;68:64-9
pubmed: 9233416
Seizure. 2007 Apr;16(3):248-53
pubmed: 17276092
Eur J Neurol. 2002 Mar;9(2):165-9
pubmed: 11882057
Pediatr Neurol. 2021 Mar;116:74-83
pubmed: 33494000
J Neurosurg. 2020 Oct 16;:1-7
pubmed: 33065538
J Neurosurg. 2018 Jul 27;:1-9
pubmed: 30052154
World Neurosurg. 2013 Jul-Aug;80(1-2):89-93
pubmed: 22484766
Epilepsia. 2007 Mar;48(3):559-63
pubmed: 17346251
J Neurosurg. 1998 Feb;88(2):293-7
pubmed: 9452238
Lancet Neurol. 2016 Feb;15(2):166-173
pubmed: 26654287
J Neurosurg. 2011 Dec;115(6):1169-74
pubmed: 21819194
J Neurosurg. 2017 Apr;126(4):1303-1311
pubmed: 27367244
Lancet Neurol. 2012 Mar;11(3):217-24
pubmed: 22297119
ScientificWorldJournal. 2015;2015:808314
pubmed: 25629087
J Neurosurg. 2000 Dec;93(6):987-91
pubmed: 11117872
Neurosurg Focus. 2010 Sep;29(3):E11
pubmed: 20809752
Eur Spine J. 2023 May;32(5):1714-1720
pubmed: 36928489
Neurosurg Rev. 2019 Jun;42(2):403-408
pubmed: 30610500
J Neurosurg. 2010 Jul;113(1):23-9
pubmed: 20170299
Neurosurgery. 2017 May 1;80(5):N25-N27
pubmed: 28586486
J Neurosurg. 2009 Jun;110(6):1179-85
pubmed: 19216651
Eur J Neurol. 2023 Jan;30(1):144-149
pubmed: 36181703
World Neurosurg. 2021 Dec;156:e359-e373
pubmed: 34560298
Neurosurgery. 2023 Sep 1;93(3):699-705
pubmed: 36999926
Neurosurg Focus. 2010 Sep;29(3):E7
pubmed: 20809765
Eur J Neurol. 2022 May;29(5):1427-1434
pubmed: 35060255
Epilepsia. 2013 Dec;54(12):2025-35
pubmed: 24134485
Trials. 2020 May 12;21(1):401
pubmed: 32398113
J Neurol Sci. 2016 Aug 15;367:15-7
pubmed: 27423555
Neurosurg Focus. 2010 Sep;29(3):E8
pubmed: 20809766
Acta Neurochir (Wien). 2011 Feb;153(2):249-59
pubmed: 21190120
J Neurosurg. 2017 Dec;127(6):1461-1466
pubmed: 29027861
Acta Neurol Scand. 2004 Dec;110(6):393-7
pubmed: 15527452
World Neurosurg. 2021 Aug;152:6-18
pubmed: 34062296
Neurology. 2016 May 24;86(21):1984-91
pubmed: 27164680
Neurosurgery. 2017 May 1;80(5):665-680
pubmed: 28387823
J Neurosurg. 2021 Oct 01;136(5):1220-1230
pubmed: 34598135
Neurosurgery. 1997 Nov;41(5):1094-100; discussion 1100-1
pubmed: 9361063
Acta Neurochir (Wien). 1996;138(6):672-7
pubmed: 8836281
J Neurosurg. 1995 Nov;83(5):825-31
pubmed: 7472550
Stroke. 2012 Dec;43(12):3196-9
pubmed: 23150651
J Neurosurg. 2018 Jul 1;:1-9
pubmed: 30052157
J Neurosurg. 2007 Sep;107(3):495-503
pubmed: 17886546
Clin Pediatr (Phila). 2014 Feb;53(2):189-90
pubmed: 23804539
Acta Neurochir (Wien). 2019 Jan;161(1):57-61
pubmed: 30448876
Yonsei Med J. 2015 Nov;56(6):1714-20
pubmed: 26446658
World Neurosurg. 2016 Jul;91:73-80
pubmed: 27058610
Epilepsia. 2006 Mar;47(3):563-6
pubmed: 16529622
Neurosurgery. 2008 Nov;63(5):888-96; discussion 897
pubmed: 19005379
Neurosurgery. 2006 Jun;58(6):1129-43; discussion 1129-43
pubmed: 16723892
J Neurosurg Spine. 2022 Nov 18;38(3):405-411
pubmed: 36401548
Mayo Clin Proc. 2020 Sep;95(9):2005-2020
pubmed: 32605781
Neurosurgery. 2017 Sep 1;81(3):498-503
pubmed: 28327920
Brain Behav. 2022 Jun;12(6):e2595
pubmed: 35470577
Neurosurgery. 2014 Jun;74(6):668-80; discussion 680-1
pubmed: 24589561
J Neurosurg. 2020 Oct 16;:1-9
pubmed: 33065532
World Neurosurg. 2016 Apr;88:631-639
pubmed: 26578351
Neurol Sci. 2006 Feb;26(6):390-4
pubmed: 16601930
Eur J Neurol. 2023 May;30(5):1346-1351
pubmed: 36773004
Clin Neurol Neurosurg. 1997 Aug;99(3):179-83
pubmed: 9350398
Stroke. 2012 Feb;43(2):571-4
pubmed: 22034008
J Neurosurg. 2006 Mar;104(3):376-81
pubmed: 16572649
J Neurosurg. 2018 Jun 1;:1-9
pubmed: 29882707
Neurology. 2020 Jul 7;95(1):e89-e96
pubmed: 32513786
J Neurol Surg A Cent Eur Neurosurg. 2021 Jan;82(1):59-63
pubmed: 33278828
J Neurosurg Spine. 2014 Oct;21(4):662-76
pubmed: 25062285
J Neurosurg. 2018 Jun 15;:1-6
pubmed: 29905510
J Neurosurg Pediatr. 2012 Feb;9(2):198-205
pubmed: 22295927
Eur J Neurol. 2021 Feb;28(2):491-499
pubmed: 32961598
Stroke. 2022 Mar;53(3):817-824
pubmed: 34706565
Neurosurgery. 2011 Jun;68(2 Suppl Operative):317-24; discussion 324
pubmed: 21368697
Neurosurgery. 2013 Apr;72(4):573-89; discussion 588-9
pubmed: 23262564
Eur J Neurol. 2023 May;30(5):1364-1370
pubmed: 36789485
J Neurosurg. 1995 Aug;83(2):237-42
pubmed: 7616268
J Neurosurg Spine. 2021 Dec 17;36(6):1030-1034
pubmed: 34920423
Neurosurgery. 1996 Jul;39(1):26-32; discussion 32-4
pubmed: 8805137
Neurosurg Focus. 2011 Jun;30(6):E24
pubmed: 21631226
J Neurol Neurosurg Psychiatry. 2013 Feb;84(2):194-200
pubmed: 23085932
Lancet Neurol. 2019 Oct;18(10):935-941
pubmed: 31401075
J Neurosurg. 2005 Jan;102 Suppl:81-6
pubmed: 15662786
JAMA Neurol. 2017 Jul 1;74(7):801-805
pubmed: 28492932
Neurosurgery. 2019 Dec 1;85(6):843-853
pubmed: 30476251
J Neurosurg. 2013 Jan;118(1):43-6
pubmed: 22998055