Surgical managements and patient outcomes after severe hemorrhagic events from brainstem cavernous malformations

Autor: Zhen Wu, Ming-Xiang Xie, Xinru Xiao, Junting Zhang, Shun-Wu Xiao, Sungel Xie, Liwei Zhang
Rok vydání: 2020
Předmět:
Zdroj: Neurosurgical Review. 44:423-434
ISSN: 1437-2320
0344-5607
DOI: 10.1007/s10143-019-01230-0
Popis: To evaluate the surgical outcomes and predictors and the impact of surgical timing of patients who suffered a severe hemorrhagic event from brainstem cavernous malformations (CMs). The clinical data of all patients who underwent surgical treatment after a severe bleeding ictus from brainstem CMs between 2011 and 2017 were retrospectively reviewed. The study population consisted of 61 surgical patients (40, 65.6% female). Surgical times of 8 weeks since the last bleeding ictus were observed in 23 (37.7%), 24 (39.3%), and 14 (23.0%) patients, respectively. The mean modified Rankin scale (mRS) score evaluated on admission was 4.2. With a mean follow-up of 39.8 months, 39 patients (63.9%) had a favorable outcome (mRS ≤ 2), and the mean mRS score was 2.3. The logistic regression analysis identified age, having disrupted consciousness and/or respiration, and time to surgery from last hemorrhage as significant predictors of long-term outcome. In particular, patients with surgery performed during the acute period ( 8 weeks, P = 0.01) tended to have poor outcomes when compared with those with surgery during the subacute period (≥ 3–8 weeks). Favorable neurological outcomes can be achieved in patients who were surgically treated after a severe hemorrhagic ictus from brainstem CMs, and operation during subacute hemorrhage (≥ 3–8 weeks) could benefit these patients.
Databáze: OpenAIRE
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