التفاصيل البيبلوغرافية
| العنوان: |
Long-term functional outcomes and complications of microsurgical resection of brainstem cavernous malformations: a systematic review and meta-analysis. |
| المؤلفون: |
Albalkhi, Ibrahem, Shafqat, Areez, Bin-Alamer, Othman, Mallela, Arka N., Kuminkoski, Chloe, Labib, Mohamed A., Lang, Michael J., Lawton, Michael T., Morcos, Jacques J., Couldwell, William T., Abou-Al-Shaar, Hussam |
| المصدر: |
Neurosurgical Review; 9/20/2023, p1-11, 11p |
| مصطلحات موضوعية: |
BRAIN stem, FUNCTIONAL status, MICROSURGERY, HUMAN abnormalities, CRANIAL nerves, ANGIOMAS, MESENCEPHALON, PROGRESSIVE supranuclear palsy |
| مستخلص: |
Brainstem cavernous malformations (CMs) encompass up to 20% of all intracranial CMs and are considered more aggressive than cerebral CMs because of their high annual bleeding rates. Microsurgical resection remains the primary treatment modality for CMs, but long-term functional outcomes and complications are heterogenous in the literature. The authors performed a systematic review on brainstem CMs in 4 databases: PubMed, EMBASE, Cochrane library, and Google Scholar. We included studies that reported on the long-term functional outcomes and complications of brainstem CMs microsurgical resection. A meta-analysis was performed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The search yielded 4781 results, of which 19 studies met our inclusion criteria. Microsurgery was performed on 940 patients (mean age 35 years, 46.9% females). Most of the brainstem CMs were located in the pons (n = 475). The pooled proportions of improved, stable, and worsened functional outcomes after microsurgical resection of brainstem CMs were 56.7% (95% CI 48.4–64.6), 28.6% (95% CI 22.4–35.7), and 12.6% (95% CI 9.6–16.2), respectively. CMs located in the medulla were significantly (p = 0.003) associated with a higher proportion of improved outcome compared with those in the pons and midbrain. Complete resection was achieved in 93.3% (95% CI 89.8–95.7). The immediate postoperative complication rate was 37.2% (95% CI 29.3–45.9), with new-onset cranial nerve deficit being the most common complication. The permanent morbidity rate was 17.3% (95% CI 10.5–27.1), with a low mortality rate of 1% from the compiled study population during a mean follow-up of 58 months. Our analysis indicates that microsurgical resection of brainstem CMs can result in favorable long-term functional outcomes with transient complications in the majority of patients. Complete microsurgical resection of the CM is associated with a lower incidence of CM hemorrhage and the morbidity related to it. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
