Qian Xiao, Ning Weihai, Liu Deshan, Qu Yanming, Zhang Hongwei
Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China.
Sci Rep. 2025 Jul 1;15(1):21298. doi: 10.1038/s41598-025-03722-0.
Hemorrhage from brainstem cavernous malformations (BSCMs) can cause severe neurological dysfunction. While surgery is effective, the optimal timing remains unclear. This retrospective study aims to identify the best timing for surgery after hemorrhage in BSCM patients. Data from patients who underwent surgery between 2012 and 2022 were analyzed. Patients were divided into groups with favorable and unfavorable outcomes based on their best post-treatment modified Rankin Scale (mRS) scores. They were further categorized into four groups according to the timing of surgery after hemorrhage: hyperacute (≤ 7 days), acute (8-20 days), subacute (21-56 days), and chronic (> 56 days). Clinical characteristics, imaging findings, prognosis, and outcomes were compared between the groups. A total of 135 BSCM patients were included, with most lesions located in the pons. Surgical timing distribution was as follows: hyperacute phase (12 cases), acute phase (42 cases), subacute phase (69 cases), and chronic phase (12 cases). Of these, 113 patients had favorable outcomes. Statistical analysis revealed a significant difference in mRS scores between the four groups, with the most pronounced differences observed between the acute/subacute phases and the hyperacute/chronic phases. In conclusion, performing surgery in the acute and subacute phases could improve neurological function in BSCM patients.
脑干海绵状血管畸形（BSCMs）出血可导致严重的神经功能障碍。虽然手术有效，但最佳时机仍不明确。这项回顾性研究旨在确定BSCM患者出血后手术的最佳时机。分析了2012年至2022年间接受手术的患者的数据。根据患者治疗后最佳改良Rankin量表（mRS）评分，将患者分为预后良好和不良两组。根据出血后手术时机，进一步将他们分为四组：超急性期（≤7天）、急性期（8 - 20天）、亚急性期（21 - 56天）和慢性期（>56天）。比较各组的临床特征、影像学表现、预后和结局。共纳入135例BSCM患者，大多数病变位于脑桥。手术时机分布如下：超急性期（12例）、急性期（42例）、亚急性期（69例）和慢性期（12例）。其中，113例患者预后良好。统计分析显示四组之间mRS评分存在显著差异，急性期/亚急性期与超急性期/慢性期之间差异最为明显。总之，在急性期和亚急性期进行手术可改善BSCM患者的神经功能。
