Affected health domains in patients with brainstem cavernous malformations

Kumar, Shivram; Lanzino, Giuseppe; Flemming, Kelly D.

doi:10.1007/s00701-019-04075-0

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…All data were assessed according to reporting standards [16]. Our results are of clinical importance, as HRQOL and other psychological data of untreated CCM patients are barely available so far [17,18]. Such data are necessary to function as benchmarks when evaluating surgical or medical treatment options for CCM [12].…”

Section: Discussionmentioning

confidence: 99%

“…Kumar et al . [18] reported on 56 untreated brainstem CCMs using the PROMIS‐29 (Patient‐Reported Outcomes Measurement Information System) questionnaire. In accordance with our findings, they described impairment in anxiety, fatigue, social and physical domains even in patients without functional impairment.…”

Section: Discussionmentioning

confidence: 99%

“…However, whilst reporting standards [16] and all larger previous series mainly focus on occurrence/rate of SH and functional impairment, the important clinical parameter health‐related quality of life (HRQOL) to estimate the burden of a disease has been nearly completely neglected in patients with CCM. Only few series [12,17–20], especially on postoperative HRQOL [12,19,20], exist.…”

Section: Introductionmentioning

confidence: 99%

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Health‐related quality of life in patients with untreated cavernous malformations of the central nervous system

Herten

Saban

et al. 2020

Euro J of Neurology

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Background and purposeTo estimate health‐related quality of life (HRQOL) in patients with untreated cavernous malformation of the CNS [cavernous cerebral malformations (CCMs)].MethodsWe performed a cross‐sectional observational study on patients with CCMs admitted to our department from 1 November 2017 to 10 January 2020 using standardized interviews [short‐form‐36 questionnaire, hospital anxiety and depression score (HADS‐A/D), CCM perception questionnaire]. Included criteria were diagnosis of an untreated CCM and information about the diagnosis in a specialized CCM consultation. Health‐related quality of life (HRQOL) data were analyzed and compared to the German normal population. Uni‐ and multivariate analyses were carried out to identify variables with impact on outcome.ResultsTwo hundred nineteen (93%) of 229 eligible patients were included. Mean age was 46.3 ± 14.7 (18–86) years; 136 (62%) were female. Ninety‐eight (45%) patients presented with symptomatic hemorrhage (SH), and 17 (8%) with repetitive SH. Ninety‐two (42%) patients were asymptomatic. Thirty‐seven patients (17%) suffered from cavernoma‐related epilepsy. Twenty‐eight patients (13%) suffered from familial CCMs. Patients showed significantly decreased component scores and subdomain scores compared to the normal population, with effects ranging from small to large. This accounted largely also for asymptomatic patients (except for physical component score and main physical subdomains). Multivariate regression analysis confirmed impact of functional impairment on physical component score. HADS‐A was significantly increased. HADS‐A/D strongly correlated with mental component score and individual perception of the CCM.ConclusionsPatients with the diagnosis of a CCM showed decreased HRQOL compared to the normal population even when not suffering functional impairment or neurological symptoms. Our data may function as benchmarks in evaluation of different (future) management strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Health‐related quality of life in patients with untreated cavernous malformations of the central nervous system

Herten

Saban

et al. 2020

Euro J of Neurology

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“…Cranial nerve deficits and brainstem symptoms, in particular, showed a significant impact on physical and mental quality of life even in favourable outcome patients [ 13 ]. Therefore, future studies on outcomes after BSCM resection should include detailed and standardised quality of life assessments to better represent individual outcomes [ 13 , 26 ]. Compared to the available literature reports, implementation of endoscopic techniques for BSCM resection does not seem to increase surgery-related morbidity.…”

Section: Discussionmentioning

confidence: 99%

Endoscope-assisted resection of brainstem cavernous malformations

et al. 2022

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Targeted surgical precision and minimally invasive techniques are of utmost importance for resectioning cavernous malformations involving the brainstem region. Minimisation of the surgical corridor is desirable but should not compromise the extent of resection. This study provides detailed information on the role of endoscopy in this challenging surgical task. A retrospective analysis of medical documentation, radiologic studies and detailed intraoperative video documentation was performed for all consecutive patients who underwent surgical resection of brainstem cavernous malformations between 2010 and 2020 at the authors’ institution. A case-based volumetry of the corticotomy was performed and compared to cavernoma dimensions. A total of 20 procedures have been performed in 19 patients. Neuroendoscopy was implemented in all cases. The mean size of the lesion was 5.4 (± 5) mm3. The average size of the brainstem corticotomy was 4.5 × 3.7 (± 1.0 × 1.1) mm, with a median relation to the cavernoma’s dimension of 9.99% (1.2–31.39%). Endoscopic 360° inspection of the resection cavity was feasible in all cases. There were no endoscopy-related complications. Mean follow-up was 27.8 (12–89) months. Gross-total resection was achieved in all but one case (95%). Sixteen procedures (80%) resulted in an improved or stable medical condition. Eleven patients (61.1%) showed further improvement 12 months after the initial surgery. With the experience provided, endoscopic techniques can be safely implemented in surgery for BSCM. A combination of neuroendoscopic visualisation and neuronavigation might enable a targeted size of brainstem corticotomy. Endoscopy can currently be considered a valuable additive tool to facilitate the preparation and resection of BSCM.

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“…These tumors have mild compression symptoms, but hemorrhagic seizures caused by brainstem cavernous hemangioma can lead to severe symptoms such as hemiparesis, respiratory dysfunction, and disorders of consciousness due to their dangerous location [16]. In addition, the impact of brainstem cavernous hemangioma on quality of life is obvious [17]. As shown in Fig.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Survival Analysis of Patients with Brainstem Cavernous Hemangioma: A Population-Based Study Using the SEER Database

Zhan

Yang

et al. 2022

Preprint

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This population-based study determined the epidemiology, incidence, and outcomes of brainstem cavernous hemangioma. Data on patients with brainstem cavernous hemangioma were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Descriptive analysis assessed the distribution and tumor-related characteristics of patients with brainstem cavernous hemangioma. The Kaplan–Meier method and Cox proportional hazard model were used to analyzed the possible prognostic indicators. The age-adjusted incidence rate between 2000 and 2019 was 0.0236 cases per 100,000 person-years. A total of 283 cases of brainstem cavernous hemangioma were identified between 2000 and 2019. The median patient age was 45 years (range, 0–87 years). Most patients were diagnosed between 40–44 and 55–59 years of age. Middle-aged adults (40–59 years old) accounted for 41.34% of all patients. White patients accounted for 82.6% of all patients. All patients diagnosed with brainstem cavernous hemangioma had benign lesions. Surgery was performed in 105 (37.1%) cases, radiation therapy in 5 (1.7%) cases, and chemotherapy in 1(0.4%) case. The median survival time was 71 months (range: 0–189 months). Age at diagnosis and surgery were two strong factors affecting occurrence and prognosis. Incidence did not differ between sexes and was higher in white patients. Tumor size had little impact on early prognosis; however, for late prognosis, smaller tumors (< 3 cm) had a better prognosis. No significant differences were observed in the outcomes between surgery and conservative treatment. We suggest that more attention should be paid to the treatment of patients with brainstem cavernous hemangioma.

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Affected health domains in patients with brainstem cavernous malformations

Cited by 5 publications

References 12 publications

Health‐related quality of life in patients with untreated cavernous malformations of the central nervous system

Health‐related quality of life in patients with untreated cavernous malformations of the central nervous system

Endoscope-assisted resection of brainstem cavernous malformations

Epidemiology and Survival Analysis of Patients with Brainstem Cavernous Hemangioma: A Population-Based Study Using the SEER Database

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