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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Artikel

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Cerebral cavernous malformations (CCM) – the second symptomatic haemorrhage – long-term follow-up

Zerebrale Kavernome – das zweite Blutungsereignis im Langzeitverlauf

Meeting Abstract

Suche in Medline nach

  • presenting/speaker Steffen Rauscher - Klinik für Neurochirurgie, Uniklinikum Essen, Essen, Deutschland
  • Annika Herten - Klinik für Neurochirurgie Uniklinikum Essen, Essen, Deutschland
  • Dino Vitali Saban - Klinik für Neurochirurgie, Uniklinikum Essen, Essen, Deutschland
  • Ramazan Jabbarli - Klinik für Neurochirurgie, Uniklinikum Essen, Essen, Deutschland
  • Karsten Wrede - Klinik für Neurochirurgie, Uniklinikum Essen, Essen, Deutschland
  • Ulrich Sure - Klinik für Neurochirurgie, Uniklinikum Essen, Essen, Deutschland
  • Philipp Dammann - Uniklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV309

doi: 10.3205/19dgnc327, urn:nbn:de:0183-19dgnc3274

Veröffentlicht: 8. Mai 2019

© 2019 Rauscher et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Risk for recurrent symptomatic hemorrhage in CCM is an important factor in decision making/consultation of patients. In this report, we analyze the risk and time pattern of re-hemorrhage events after a first initial bleeding.

Methods: We performed a cross-sectional study based on our uni-center CCM database (2003–2018), analyzing the further follow-up of patients with a first symptomatic hemorrhage. Kaplan-Meier and survival analysis were performed to estimate cumulative re-bleeding risks and time distribution of re-hemorrhage events (patients undergoing surgery were excluded).

Results: We included a consecutive series of n=461 (48% of n=1004) qualified patients. 114 (24.6%) suffered a second hemorrhage. Annual risk of hemorrhage was 11%, 12%, 6%, 7%, 6%, 11%, 2%, 5%, 0%, 0% in the first ten years, respectively. 5-year cumulative risk of re-hemorrhage was 42%, ten-year risk was 60%. Independent risk factor for re-hemorrhage was brainstem location.

Conclusion: While absolute cumulative re-bleeding risk estimation may be exaggerated by the high level of exclusion due to surgical treatment, our results reflect a “wavelike” time pattern of re-hemorrhages which gradually declines after two peaks (1st and 5th year) and reach a plateau at year 8.