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The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations
Microsurgical resection of brainstem cavernous malformations (BSCMs) can be performed today with acceptable morbidity and mortality. However, in this highly eloquent location, the indication for surgery remains challenging. We aimed to elaborate a score system that may help clinicians with their cho...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976795/ https://www.ncbi.nlm.nih.gov/pubmed/34713352 http://dx.doi.org/10.1007/s10143-021-01679-y |
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author | Yang, Yang Velz, Julia Neidert, Marian C. Lang, Wei Regli, Luca Bozinov, Oliver |
author_facet | Yang, Yang Velz, Julia Neidert, Marian C. Lang, Wei Regli, Luca Bozinov, Oliver |
author_sort | Yang, Yang |
collection | PubMed |
description | Microsurgical resection of brainstem cavernous malformations (BSCMs) can be performed today with acceptable morbidity and mortality. However, in this highly eloquent location, the indication for surgery remains challenging. We aimed to elaborate a score system that may help clinicians with their choice of treatment in patients with BSCMs in this study. A single-center series of 88 consecutive BSCMs patients with 272 follow-up visits were included in this study. Univariable and multivariable generalized estimating equations (GEE) were constructed to identify the association of variables with treatment decisions. A score scale assigned points for variables that significantly contributed to surgical decision-making. Surgical treatment was recommended in 37 instances, while conservative treatment was proposed in 235 instances. The mean follow-up duration was 50.4 months, and the mean age at decision-making was 45.9 years. The mean BSCMs size was 14.3 ml. In the multivariable GEE model, patient age, lesion size, hemorrhagic event(s), mRS, and axial location were identified as significant factors for determining treatment options. With this proposed score scale (grades 0–XII), non-surgery was the first option at grades 0–III. The crossover point between surgery and non-surgery recommendations lay between grades V and VI while surgical treatment was found in favor at grades VII–X. In conclusion, the proposed BSCM operating score is a clinician-friendly tool, which may help neurosurgeons decide on the treatment for patients with BSCMs. |
format | Online Article Text |
id | pubmed-8976795 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-89767952022-04-07 The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations Yang, Yang Velz, Julia Neidert, Marian C. Lang, Wei Regli, Luca Bozinov, Oliver Neurosurg Rev Original Article Microsurgical resection of brainstem cavernous malformations (BSCMs) can be performed today with acceptable morbidity and mortality. However, in this highly eloquent location, the indication for surgery remains challenging. We aimed to elaborate a score system that may help clinicians with their choice of treatment in patients with BSCMs in this study. A single-center series of 88 consecutive BSCMs patients with 272 follow-up visits were included in this study. Univariable and multivariable generalized estimating equations (GEE) were constructed to identify the association of variables with treatment decisions. A score scale assigned points for variables that significantly contributed to surgical decision-making. Surgical treatment was recommended in 37 instances, while conservative treatment was proposed in 235 instances. The mean follow-up duration was 50.4 months, and the mean age at decision-making was 45.9 years. The mean BSCMs size was 14.3 ml. In the multivariable GEE model, patient age, lesion size, hemorrhagic event(s), mRS, and axial location were identified as significant factors for determining treatment options. With this proposed score scale (grades 0–XII), non-surgery was the first option at grades 0–III. The crossover point between surgery and non-surgery recommendations lay between grades V and VI while surgical treatment was found in favor at grades VII–X. In conclusion, the proposed BSCM operating score is a clinician-friendly tool, which may help neurosurgeons decide on the treatment for patients with BSCMs. Springer Berlin Heidelberg 2021-10-29 2022 /pmc/articles/PMC8976795/ /pubmed/34713352 http://dx.doi.org/10.1007/s10143-021-01679-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Yang, Yang Velz, Julia Neidert, Marian C. Lang, Wei Regli, Luca Bozinov, Oliver The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations |
title | The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations |
title_full | The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations |
title_fullStr | The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations |
title_full_unstemmed | The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations |
title_short | The BSCM score: a guideline for surgical decision-making for brainstem cavernous malformations |
title_sort | bscm score: a guideline for surgical decision-making for brainstem cavernous malformations |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976795/ https://www.ncbi.nlm.nih.gov/pubmed/34713352 http://dx.doi.org/10.1007/s10143-021-01679-y |
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