Neurological outcome of untreated brainstem CMs
| Study and year | Study type | Patients (n) | Mean age, years | Mean follow-up, years | Patients with prospective ictus (%) | Total number of ictus | Annual haemorrhage rate, % | Neurological outcome (%) |
| Zimmerman et al 199130 | Retrospective | 8 | NA | 3–60 months | 1 (12.5) | 1 | NA | 7 (87.5) minor symptoms or asymptomatic; 1 (12.5) died of haemorrhage. |
| Fritschi et al 199426 | Retrospective | 30 | NA | 3.0 | NA | NA | NA | 13 (43.3) normal; 7 mildly, 2 moderately and 2 severely disabled; 6 (20.0) died of CMs. |
| Bouillot et al 199629 | Retrospective | 7 | NA | 5.6 | NA | NA | 11.7 | 1 (14.3) improved; 4 (57.1) same; 2 (28.6) worsened. |
| Porter et al 199920 | Retrospective | 12 | NA | NA | NA | NA | NA | 7 (58.3) improved/same; 5 (41.7) worsened; 1 (8.3) died of rebleeding. |
| Kupersmith et al 200112 | Retrospective | 37 | 37.5 | 4.9 | 7 (18.9) | 8 | 5.1 | 18 (48.6) improved; 14 (37.8) same; 3 (8.1) worsened; 2 (5.4) died of myocardial infarction. |
| Esposito et al 200332 | Retrospective | 17 | NA | NA | NA | NA | 2.5 | 11 (64.7) favourable; 5 (29.4) same; 1 (5.9) worsened. |
| Tarnaris et al 200828 | Retrospective | 15 | 37.9 | 6.1 | 4 (26.7) | 4 | 4.4 | 2 (13.3) improved; 5 (33.3) same; 8 (53.3) worsened; mean mRS score 2.07. |
| Bhardwaj et al 200931 | Retrospective | 13‡ | 12.7 | 4.4 | 1 (7.7) | 1 | ≈1.7 | 4 (30.8) improved; 8 (61.5) same (6 asymptomatic, 2 symptomatic); 1 (7.7) died. |
| Chen et al 201121 | Retrospective | 20 | 38.1 | 3.7 | 7 (35.0) | ≥11 | NA | Mean NIHSS score 1.7. |
| Menon et al 201127 | Retrospective | 29† | NA | 4.0 | 17 (63.0) | ≥41 | ≥35.3 | 14 (51.9) improved/same; 13 (48.1) worsened; 1 (3.7) died of haemorrhage. |
| Al-Holou et al 20128 | Retrospective | 15 les | NA | ≈3.5 | 5 les (33.3) | 8 | ≈15.2 per les | NA |
| Al-Shahi Salman et al 20122 | Prospective | 14 | NA | 5.0 | NA | NA | NA | 8 patients (57.1) had a second haemorrhage or focal neurological deficit. |
| Li et al 201417 | Prospective | 85 | 12.7 | 4.7 | 37 (43.5) | 47 | 11.7 | 22 (25.9) normal; 33 (38.8) improved; 32 (37.6) same; 20 (23.5) worsened. |
| Li et al 201417 | Prospective | 331 | 36.2 | 6.5 | 131 (39.6) | 185 | 13.6 | 95 (28.7) normal; 198 (59.8) improved; 109 (32.9) same; 24 (7.3) worsened; 3 (0.9) deaths. |
| Gross et al 20165 | Retrospective | 18 lesion | NA | 3.3 | NA | 10 | 16.7 per lesion | Permanent neurological morbidity of 45% for brainstem, thalamic and basal ganglia CMs. |
| Horne et al 20163 | Meta-analysis | 575 | NA | NA | 139 (24.2) | 139 | NA | NA |
| Zuurbier et al 201914 | Prospective | 34 | NA | NA | NA | 15 | NA | 15 events of haemorrhage or persistent or progressive focal neurological deficit. |
| Present series | Prospective | 698 | 38.3 | 4.7 | 167 (23.9) | 222 | 6.7 | 233 (33.4) normal; 334 (47.9) improved/mRS=0, 293 (42.0) same; 71 (10.2) worsened. |
*Two patients were lost to follow-up; 5 had one haemorrhage and 12 had more than two haemorrhages during follow-up.
†Seven patients had previous radiotherapy and one patient died of medulloblastoma.
CMs, cavernous malformations; les, lesions; mRS, modified Rankin Scale; NA, not available; NIHSS, National Institutes of Health Stroke Scale.