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The study confirms that CCM development relies not only on genetic mutations but also on the synergistic effects of a \u201csecond hit\u201d mechanism and microenvironmental stressors. Immune cell infiltration (e.g., B cells, T cells, neutrophils) and oxidative stress responses play pivotal roles in lesion progression; Blood\u2010brain barrier disruption and immune thrombosis further exacerbate the pathological process. These findings provide theoretical foundations for understanding CCM's multifactorial pathogenic network and establish scientific bases for personalized therapeutic strategies targeting the immune microenvironment and oxidative stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Genetic mutations trigger the formation of initial CCM lesions, while environmental and immune factors promote disease progression, increasing the risk of abnormal cerebral vascular formation or rupture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71237","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T16:00:46Z","timestamp":1769875246000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Role of Immune Infiltration and Oxidative Stress in the Progression of Cerebral Cavernous Malformation"],"prefix":"10.1002","volume":"16","author":[{"given":"Xuesai","family":"Zhu","sequence":"first","affiliation":[{"name":"Central Laboratories Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences  Qingdao Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhi","family":"Yao","sequence":"additional","affiliation":[{"name":"Central Laboratories Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences  Qingdao Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengbo","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Key Laboratory of Orthopedics, Sports Medicine &amp; 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