Related Experiment Video
Updated: Jun 2, 2026
12:31
A Visual Description of the Dissection of the Cerebral Surface Vasculature and Associated Meninges and the Choroid Plexus from Rat Brain
Published on: November 14, 2012
A proposed grading system of brain and spinal cavernomas
Juri Kivelev1, Aki Laakso, Mika Niemelä
1Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland. juri.kivelev@hus.fi
Neurosurgery
|April 22, 2011
Summary
A new grading system helps predict long-term outcomes for patients undergoing surgery for central nervous system cavernomas. This system identifies key risk factors like location and neurological deficits, improving patient outcome prediction.
Area of Science:
- Neurosurgery
- Neurology
- Medical Statistics
Background:
- Central nervous system (CNS) cavernomas are typically benign but may require surgical intervention for progressive symptoms.
- Predicting long-term outcomes after cavernoma surgery remains challenging due to unconfirmed risk factors in existing literature.
Purpose of the Study:
- To conduct a multifactorial analysis of risk factors in a large cohort of surgically treated CNS cavernoma patients.
- To develop and validate a simple grading scale for predicting long-term postoperative outcomes.
Main Methods:
- A retrospective study of 303 consecutive patients with CNS cavernomas treated surgically between 1980 and 2009.
- Long-term follow-up (average 5.7 years) assessed using the Glasgow Outcome Scale, dichotomized into favorable (GOS 5) and unfavorable (GOS 1-4) outcomes.
- Binary logistic regression analysis identified independent risk factors including age, sex, seizures, neurological deficits, hemorrhage, and cavernoma characteristics (size, location).
Main Results:
- Infratentorial, basal ganglia, or spinal location and preexisting neurological deficits were independent predictors of unfavorable outcomes (RR 2.7 and 3.2, respectively).
- A novel 3-grade scoring system was developed, showing strong correlation with patient outcomes (P < .001).
- The proposed grading system predicted long-term unfavorable outcomes of 13% (Grade 1), 22% (Grade 2), and 55% (Grade 3).
Conclusions:
- The developed grading system effectively correlates with postoperative outcomes in patients with surgically treated CNS cavernomas.
- This tool can aid in predicting long-term prognosis and guiding clinical decision-making for cavernoma management.
Related Concept Videos
01:18Anatomy of the Brain: Ventricles
There are hollow fluid-filled cavities known as ventricles deep inside the human brain. There are two lateral ventricles, one in each cerebral hemisphere, and each has three different projections — the anterior, inferior, and posterior horns visible from the lateral side. A thin membrane called the septum pellucidum separates the two lateral ventricles. The slender third ventricle in the diencephalon is connected to each lateral ventricle via a channel called the interventricular foramen. The...
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:19Cranial and Spinal Meninges
The cranial and spinal meninges are complex protective structures surrounding the central nervous system (CNS), consisting of the brain and spinal cord. These meninges consist of the dura mater, the arachnoid mater, and the pia mater. They protect the CNS, provide structural support, and aid in circulating cerebrospinal fluid (CSF).
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
Cranial Meninges
These meningeal layers cover the cranium. The dura mater is the outermost layer of cranial meninges. It is a thick and durable membrane of dense...
01:21Cerebrospinal Fluid
Cerebrospinal fluid (CSF) is a colorless liquid that flows around the brain and the spinal cord, playing a vital role in the protection, support, and overall function of the central nervous system (CNS). CSF production, circulation, and absorption are tightly regulated processes essential for the brain and spinal cord to function properly.
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...