Ene Chibawanye, Kaul Anand, Kim Louis
Department of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Department of Neurological Surgery, Harborview Medical Center, University of Washington, Seattle, WA, USA.
Handb Clin Neurol. 2017;143:227-232. doi: 10.1016/B978-0-444-63640-9.00021-7.
Cerebral cavernous malformations (CCM) are vascular abnormalities of the central nervous system with an incidence of 0.4-0.5% and an annual rate of hemorrhage ranging from 0.7% to 1%. Most lesions are located in the cerebral hemisphere but some occur in deeper locations such as the basal ganglia and pons. The most common symptoms during presentation are headache, seizures, and focal neurologic deficits. Surgery remains the most effective treatment modality for symptomatic CCM, while the management of incidental CCM remains controversial. Factors associated with increased risk of hemorrhage include being female and less than 40 years old. This finding, however, is not consistent in all natural history studies evaluated. During follow-up, the most important and consistent risk factor for rebleed was a prior hemorrhage. Here, we provide an indepth but concise review of the literature regarding the natural history of CCMs.
脑海绵状血管畸形（CCM）是中枢神经系统的血管异常，发病率为0.4-0.5%，年出血率为0.7%至1%。大多数病变位于大脑半球，但有些发生在更深的部位，如基底神经节和脑桥。就诊时最常见的症状是头痛、癫痫发作和局灶性神经功能缺损。手术仍然是有症状CCM最有效的治疗方式，而偶然发现的CCM的管理仍存在争议。与出血风险增加相关的因素包括女性和年龄小于40岁。然而，这一发现并非在所有评估的自然史研究中都一致。在随访期间，再出血最重要且一致的风险因素是既往出血。在此，我们对关于CCM自然史的文献进行了深入而简洁的综述。
