Related Experiment Video
Updated: Oct 6, 2025
Induction and Micro-CT Imaging of Cerebral Cavernous Malformations in Mouse Model
Published on: September 4, 2017
Natural History of Spinal Cord Cavernous Malformations: A Multicenter Cohort Study
Jian Ren1, Nan Jiang1, Lisong Bian2
1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, China International Neuroscience Institute, Beijing, China.
Insights
The natural history of spinal cord cavernous malformations (SCCMs) varies. Prior hemorrhage and pediatric cases predict future bleeding, while baseline status and new hemorrhages impact neurological outcomes.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Malformations
Background:
- The natural history and progression of spinal cord cavernous malformations (SCCMs) are not well understood.
- SCCMs can lead to significant neurological deficits and pose risks of hemorrhage.
Purpose of the Study:
- To investigate the natural history of SCCMs, focusing on hemorrhagic risks and neurological outcomes.
- To identify factors that predict these outcomes in patients with SCCMs.
Main Methods:
- Retrospective observational study of 305 patients diagnosed with SCCMs between 2002 and 2019.
- Analysis of 126 patients under conservative management for at least 6 months, with a median follow-up of 24 months.
Main Results:
- An annual hemorrhage rate of 8.5% was observed, with 5-year cumulative risk at 35.1%.
- Prior hemorrhage and pediatric status were independent predictors of hemorrhage.
- Familial form, subsequent hemorrhages, baseline neurological status, and recurrent bleeding significantly impacted neurological function and outcomes.
Conclusions:
- The natural history of SCCMs is variable and influenced by several factors.
- Baseline characteristics (pediatric, familial, neurological status) and hemorrhage history are critical.
- These findings support the need for individualized treatment strategies for SCCMs.
Background:
The natural history of spinal cord cavernous malformations (SCCMs) remains relatively unclear.
Objective:
To investigate the natural history for hemorrhagic risks and neurological outcomes, as well as relevant predicting factors, of SCCMs.
Methods:
All patients between 2002 and 2019 with diagnosis of SCCMs were identified retrospectively. An observational study of patients with conservative management was performed to reveal the natural history of SCCMs.
Results:
We identified 305 patients in the full cohort, including 126 patients who were conservatively treated for at least 6 months (median observational period, 24.0 months). Forty-five hemorrhage events occurred during 527 person-years of follow-up, yielding an annual hemorrhage rate of 8.5% per person-year. The 1-, 2-, and 5-year cumulative risks of hemorrhage were 13.9%, 26.1%, and 35.1%, respectively. Prior hemorrhage (hazard ratio [HR] = 12.948, P = .012) and pediatric patients (HR = 2.841, P = .031) were independent predictors of hemorrhage in the long-term follow-up. Familial form (adjusted odds ratio [OR] = 30.695, P = .010) and subsequent hemorrhage events (adjusted OR = 16.333, P = .000) were independent risk factors for worsening of neurological function, and baseline neurological status (adjusted OR = 78.984, P = .000) and presence of subsequent hemorrhage (adjusted OR = 9.611, P = .001) were significantly associated with neurological outcomes.
Conclusion:
The natural history of SCCMs varies. Baseline characteristics, such as pediatric patients, familial form, and baseline neurological status, as well as prior and subsequent hemorrhagic events, significantly affect the natural history of the SCCMs, which prompts a differentiated treatment strategy.
Related Concept Videos
01:16Spinal Cord: Cross-sectional Anatomy
Gray Matter and its Components
Central to the gray matter is...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:15Spinal Cord: Gross Anatomy
01:54The Spinal Cord