{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T09:41:52Z","timestamp":1770284512161,"version":"3.49.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Symptomatic brainstem cavernous malformations (BSCMs) pose a high risk of morbidity and mortality due to recurrent hemorrhage, warranting aggressive management. However, few studies have compared the effectiveness of different treatment modalities for BSCMs. We aimed to assess the association of treatment modalities with recurrent hemorrhage and neurological outcomes in patients with BSCM.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We conducted a retrospective cohort study using an observational registry database covering population of southwest and southeast China. Adult patients with BSCM were included and followed up between March 1, 2011, to March 31, 2023. We compared outcomes between microsurgery and stereotactic radiosurgery (SRS) in propensity score-matched case pairs, incorporating demographic, medical history, and lesion characteristics. The outcomes studied included recurrent hemorrhage and poor prognosis (defined as a Glasgow Outcome Scale score, &lt;4). Absolute rate differences and hazard ratios (HRs) with 95% CIs were calculated using Cox models.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Among 736 diagnosed patients with BSCM, 96 (48 matched pairs) were included after exclusions and propensity score matching (mean age, 43.1 [SD, 12.1] years; 50% women). During the median 5-year follow-up, no significant differences in recurrent hemorrhage (4.2% [microsurgery] versus 14.6% [SRS], HR, 3.90 [95% CI, 0.46\u201332.65]; <jats:italic toggle=\"yes\">P<\/jats:italic>=0.21) and poor prognosis (12.5% [microsurgery] versus 8.3% [SRS], HR, 0.29 [95% CI, 0.08\u20131.08]; <jats:italic toggle=\"yes\">P<\/jats:italic>=0.07) were observed between microsurgery and SRS recipients. Furthermore, either microsurgery or SRS correlated with fewer recurrent hemorrhage (HR, 0.09 [95% CI, 0.02\u20130.39]; <jats:italic toggle=\"yes\">P<\/jats:italic>=0.001; HR, 0.21 [95% CI, 0.07\u20130.69]; <jats:italic toggle=\"yes\">P<\/jats:italic>=0.01) compared with conservative treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>In this study, both microsurgery and SRS were safe and effective for BSCM, demonstrated comparable outcomes in recurrent hemorrhage and poor prognosis. However, interpretation should be cautious due to the potential for residual confounding.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>URL: https:\/\/www.chictr.org.cn\/; Unique identifier: ChiCTR2300070907.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.046203","type":"journal-article","created":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T09:00:42Z","timestamp":1711875642000},"page":"1151-1160","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Treatment Modalities and Outcomes in Brainstem Cavernous Malformations: A Large Multicenter Observational Cohort Study"],"prefix":"10.1161","volume":"55","clinical-trial-number":[{"clinical-trial-number":"chictr2300070907","registry":"10.18810\/chictr"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4879-0729","authenticated-orcid":false,"given":"Junlin","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (J.L., H.D., W.W., C.Y., R.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zongze","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China (Z.L., W.Z.)."},{"name":"National Center for Neurological Disorders, Shanghai, China (Z.L., W.Z.)."},{"name":"Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, China (Z.L., W.Z.)."},{"name":"Neurosurgical Institute of Fudan University, Shanghai, China (Z.L., W.Z.)."},{"name":"Shanghai Clinical Medical Center of Neurosurgery, China (Z.L., W.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (J.L., H.D., W.W., C.Y., R.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2884-7812","authenticated-orcid":false,"given":"Guangchao","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Peking University International Hospital, Beijing, China (G.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (J.L., H.D., W.W., C.Y., R.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"You","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (J.L., H.D., W.W., C.Y., R.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7190-7476","authenticated-orcid":false,"given":"Wei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, China (Z.L., W.Z.)."},{"name":"National Center for Neurological Disorders, Shanghai, China (Z.L., W.Z.)."},{"name":"Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, China (Z.L., W.Z.)."},{"name":"Neurosurgical Institute of Fudan University, Shanghai, China (Z.L., W.Z.)."},{"name":"Shanghai Clinical Medical Center of Neurosurgery, China (Z.L., W.Z.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0911-6766","authenticated-orcid":false,"given":"Rui","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China (J.L., H.D., W.W., C.Y., R.T.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"R1-20250410","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S1474-4422(12)70004-2","article-title":"Untreated clinical course of cerebral cavernous malformations: a prospective, population-based cohort study.","volume":"11","author":"Al-Shahi Salman","year":"2012","journal-title":"Lancet Neurol"},{"key":"R2-20250410","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1212\/WNL.0b013e318248de9b","article-title":"Prospective hemorrhage risk of intracerebral cavernous 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