Robinson J R, Awad I A, Magdinec M, Paranandi L
Department of Neurological Surgery, Cleveland Clinic Foundation, Ohio.
Neurosurgery. 1993 May;32(5):730-5; discussion 735-6. doi: 10.1227/00006123-199305000-00005.
The factors predisposing to an aggressive clinical course in cavernous malformations of the brain are not known. Disabilities from neurological deficits and from seizures were assessed and graded in 84 patients harboring 100 cavernous malformations and were correlated with patient sex and age, lesion size, lesion location, lesion multiplicity, and previous overt hemorrhage. Univariate analysis showed that female sex, infratentorial lesion location, and previous gross hemorrhage were significantly associated with subsequent neurological disability. Logistic regression analysis showed that infratentorial lesion location and previous gross hemorrhage were independent factors simultaneously and significantly associated with neurological disability. Age less than 40 was the only significant factor predisposing to seizure disability (in both univariate and multivariate analyses). Lesion size, multiplicity, and other factors did not influence clinical disability. This information should assist in management decisions regarding cavernous malformations.
脑海绵状血管畸形发展为侵袭性临床病程的诱发因素尚不清楚。对84例患有100个海绵状血管畸形的患者的神经功能缺损和癫痫所致残疾进行了评估和分级，并将其与患者的性别、年龄、病变大小、病变位置、病变数量及既往明显出血情况进行关联分析。单因素分析显示，女性、幕下病变位置及既往大出血与随后的神经功能残疾显著相关。逻辑回归分析表明，幕下病变位置和既往大出血是同时与神经功能残疾显著相关的独立因素。年龄小于40岁是导致癫痫残疾的唯一显著因素（单因素和多因素分析均如此）。病变大小、数量及其他因素不影响临床残疾情况。这些信息应有助于指导有关海绵状血管畸形的治疗决策。
