Infratentorial Cerebral Cavernous Malformation May be a Risk Factor for Symptomatic Bleeding and Precocity of...

Area of Science:

• Neurosurgery
• Neurology
• Vascular Malformations

Background:

• Cerebral Cavernous Malformation (CCM) is a common central nervous system vascular malformation.
• Clinical manifestations include hemorrhage, seizures, and lesion growth, with unpredictable courses.
• Risk factors for CCM progression remain incompletely understood.

Purpose of the Study:

• To investigate differential clinical data in patients with supra- and infratentorial CCMs.
• To identify anatomical location-specific risk factors for CCMs.
• To understand the neurosurgical implications of CCM location.

Main Methods:

• Multicenter, Propensity Score Matched (PSM) case-control study.
• Inclusion of 149 consecutive CCM cases evaluated between May 2017 and December 2022.
• Logistic regression and Kaplan-Meier curves used to analyze bleeding risk and symptom onset.

Main Results:

• Infratentorial lesions identified as a significant risk factor for bleeding (OR: 3.23, P=0.005) and after PSM (OR: 4.56, P=0.008).
• Infratentorial CCMs were associated with earlier symptom onset (P=0.0328 overall, P=0.03 in PSM group).
• PSM strategy balanced covariates to compare bleeding risk.

Conclusions:

• Infratentorial cerebral cavernous malformations exhibit a more aggressive clinical course.
• Location in the infratentorial space is a risk factor for symptomatic hemorrhage.
• Infratentorial CCMs are associated with precocity of bleeding events.