{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:18:30Z","timestamp":1792736310117,"version":"4.5.0"},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n This study reports the natural history of cerebral cavernous malformations (CCMs) in a contemporary cohort with prospectively collected data from multiple sources, access to follow-up imaging, integrated electronic medical records, and detailed imaging review by study investigators. The authors aimed to define the first prospective symptomatic hemorrhage (SH) and severe SH rates, determine the risk of a second prospective SH, and identify risk factors for SH.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n From a prospectively maintained database of adult patients with radiologically defined CCM, those with radiation-induced CCM, those who underwent surgery within 3 months postdiagnosis, and those with < 1 year of follow-up were excluded. The patients\u2019 medical history and radiological features of the CCM were recorded at the time of diagnosis. Follow-up annual written surveys were completed for 5 years after the initial diagnosis and then semiannually thereafter in addition to medical record and follow-up imaging review. Outcomes of interest included SH and severe SH.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of 315 patients, 58.7% were female and 19.7% had familial CCMs. At diagnosis, 37.1% of patients had ruptured CCMs and 28.9% of the CCMs were located in the brainstem. The 5-year cumulative rates of prospective SH and severe SH in those with ruptured CCMs at diagnosis were 41.2% and 12.8%, respectively, compared with 6.1% and 2.5% in patients with unruptured CCMs at diagnosis (p < 0.0001). Risk factors for prospective SH included a ruptured CCM at diagnosis and persistent or new hyperintensity on T1-weighted MRI performed > 3 months after baseline MRI. For those with a ruptured CCM at diagnosis, the risk of developing a second prospective SH was similar to that of developing a first SH.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In a contemporary cohort of adult patients with CCM, the authors report 5-year SH and severe SH rates, rates of second prospective hemorrhage, and predictors of SH. Persistent or new hyperintensity on T1-weighted MRI may be a useful marker of disease activity.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2024.2.jns232750","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T21:17:55Z","timestamp":1716585475000},"page":"1159-1167","source":"Crossref","is-referenced-by-count":8,"title":["Contemporary cohort of cerebral cavernous malformations: natural history and utility of follow-up MRI"],"prefix":"10.3171","volume":"141","author":[{"given":"Kelly D.","family":"Flemming","sequence":"first","affiliation":[{"name":"Departments of Neurology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Departments of Neurology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"},{"name":"Radiology, Division of Neuroradiology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Mayo Clin Proc","first-page":"2005","article-title":"Cerebral cavernous malformation: what a practicing clinician should know","volume":"95","author":"Flemming KD","year":"2020","unstructured":"Flemming KD, Lanzino G. Cerebral cavernous malformation: what a practicing clinician should know. Mayo Clin Proc. 2020;95(9):2005\u20132020."},{"issue":"4","key":"b2","series-title":"J Neurosurg","first-page":"1079","article-title":"Hemorrhage from cerebral cavernous malformations: a systematic pooled analysis","volume":"126","author":"Gross BA","year":"2017","unstructured":"Gross BA, Du R. Hemorrhage from cerebral cavernous malformations: a systematic pooled analysis. J Neurosurg. 2017;126(4):1079\u20131087."},{"issue":"2","key":"b3","series-title":"Lancet Neurol","first-page":"166","article-title":"Clinical course of untreated cerebral cavernous malformations: a meta-analysis of individual patient data","volume":"15","author":"Horne MA","year":"2016","unstructured":"Horne MA, Flemming KD, Su IC, Clinical course of untreated cerebral cavernous malformations: a meta-analysis of individual patient data. Lancet Neurol. 2016;15(2):166\u2013173."},{"key":"b4","series-title":"World Neurosurg","first-page":"241","article-title":"Hemorrhage, seizures, and dynamic changes of familial versus nonfamilial cavernous malformation: systematic review and meta-analysis","volume":"126","author":"Taslimi S","year":"2019","unstructured":"Taslimi S, Ku JC, Modabbernia A, Macdonald RL. Hemorrhage, seizures, and dynamic changes of familial versus nonfamilial cavernous malformation: systematic review and meta-analysis. World Neurosurg. 2019;126:241\u2013246."},{"issue":"5","key":"b5","series-title":"J Am Med Inform Assoc","first-page":"967","article-title":"Electronic health records and clinician burnout: a story of three eras","volume":"28","author":"Johnson KB","year":"2021","unstructured":"Johnson KB, Neuss MJ, Detmer DE. Electronic health records and clinician burnout: a story of three eras. 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