Cerebral Cavernous Malformation: The Impact of Associated Developmental Venous Anomaly on Surgical Treatment Outcome

The goal of this study was to analyze retrospectively the course of patients with cerebral cavernous malformation (CCM) and associated developmental venous anomaly (DVA) concerning neurological outcome and formation of CCM recurrence or de-novo formation after surgical removal of the lesion.

1469 patients diagnosed with CCM were referred to our institution from 2003 to 2022. Adult patients with sporadic CCM, complete magnetic resonance imaging dataset, and ≥2 follow-up (FU) investigations after surgical resection were analyzed. Patient's clinical data, surgical, and radiological reports were retrospectively assessed. Multiple factors regarding functional outcome were scanned using logistic regression analyses with P < 0.05. Preoperative and postoperative neurological function was assessed using the modified Rankin Scale (mRS).

183 patients were included in this study; 59 of 183 presented associated DVA. Mean preoperative mRS in the CCM + DVA group was 1.7 (±0.9), and in the CCM-DVA group was 1.97 (±0.8), while mean mRS at the last FU was 0.65 (±0.89) in the CCM + DVA group and 0.93 (±0.92) in the CCM-DVA group. Recurrence of CCM lesion was seen in 1 case in the CCM + DVA group and in 2 cases in the CCM-DVA group. Significant differences in the neurological status preoperatively (P = 0.046) and at the last FU (P = 0.049) could be detected for the benefit of the CCM + DVA group.

DVA does not represent an additional risk for neurological deterioration in the surgical resection of CCM. Postoperative CCM recurrence is negligible.