gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Surgical treatment of brainstem cavernous calformations – an international Delphi consensus

Chirurgische Behandlung kavernöser Hirnstammfehlbildungen – ein internationaler Delphi-Konsens

Meeting Abstract

  • presenting/speaker Philipp Dammann - University Hospital Essen, Essen, Essen, Deutschland
  • Alejandro Nicolas Santos - University Hospital Essen, Essen, Essen, Deutschland
  • Laurèl Rauschenbach - University Hospital Essen, Essen, Deutschland
  • Marvin Darkwah Oppong - University Hospital Essen, Essen, Essen, Deutschland
  • Ramazan Jabbarli - University Hospital Essen, Essen, Essen, Deutschland
  • Karsten Henning Wrede - University Hospital Essen, Essen, Essen, Deutschland
  • Karl Schaller - Hopitaux Universitaires de Geneve, Department of Neurosurgery, Genf, Schweiz
  • Michael T. Lawton - Barrow Neurological Institute, Neurosurgery, Phoenix, AZ, Vereinigte Staaten
  • Ulrich Sure - University Hospital Essen, Essen, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV220

doi: 10.3205/21dgnc213, urn:nbn:de:0183-21dgnc2132

Published: June 4, 2021

© 2021 Dammann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Indication for surgery in brainstem cavernous malformations (BSCM) is based on many case series, few comparative studies, and no randomised controlled trials. The objective of this trial was to seek consensus about the surgical management of BSCM.

Methods: A total of 29 experts were invited to participate in a multistep Delphi consensus process on the surgical treatment of BSCM.

Results: 22/29 (76%) experts participated in the consensus. Qualitative analysis (content analysis) of an initial open-end question survey resulted in 99 statements regarding surgical treatment of BSCM. By a multistep survey with 100% participation in each round, consensus was reached on 52 out of 99 (53%) statements. These were grouped into 4 categories: (1) definitions and reporting standards (7/14, 50%); (2) general and patient-related aspects (11/16, 69%); (3) anatomical-, timing of surgery- and BSCM-related aspects (22/37, 59%); and (4) clinical situation-based decision making (12/32, 38%). Among other things, a consensus was reached for surgical timing, handling of associated developmental venous anomalies, handling of postoperative BSCM remnants, assessment of specific anatomical BSCM localizations and treatment decisions in typical clinical BSCM scenarios.

Conclusion: A summary of typical clinical scenarios and a “catalogue” of various BSCM- and patient-related aspects that influence the surgical treatment decision have been defined and interpreted. Our results provide information that support experts in clinical routine and may serve as a foundation for clinical trial designs and treatment guidelines.