Hemorrhage From Cavernous Malformations of the Brain Definition and Reporting Standards
Hemorrhage From Cavernous Malformations of the Brain Definition and Reporting Standards
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DOI：
10.1161/strokeaha.108.515544
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发表时间：
2008-12-01
期刊：
影响因子：
8.3
通讯作者：
Awad, Issam A.
中科院分区：
文献类型：
--
作者：
Salman, Rustam Al-Shahi;Berg, Michel J.;Awad, Issam A.
背景和目的-脑海绵状血管畸形（CM）引起颅内出血，但其报道频率不同，部分归因于研究设计。为了提高未来研究的有效性，我们的目的是发展一个强大的CM出血的定义。方法：我们系统地回顾了已发表的文献（奥维德Medline和Embase至2007年6月1日），用于研究≥ 20名CM受试者的未经治疗的临床过程中使用的CM出血定义，在血管瘤联盟的科学研讨会上，告知关于CM出血的临床和成像特征的共识声明的发展。结果-对1426篇关于人类CM的出版物的系统综述，有15项研究符合我们的纳入标准。尽管14项（93%）研究提供了CM出血的定义，但关于影像学的确证类型（87%）、CM出血是否应具有临床症状（73%）以及出血是否必须扩展到CM之外（47%）的数据不太完整。我们将CM出血定义为需要急性或亚急性发作症状（头痛、癫痫发作、意识受损或与CM解剖位置相关的新发/恶化的局灶性神经功能缺损中的任何一种），伴有近期病灶外或病灶内出血的放射学、病理学、手术或极少数仅脑脊液证据。该定义既不包括CM直径的增加，没有其他证据表明最近出血，也不存在含铁血黄素halo. Conclusions临床和脑成像分类CM出血的一致方法将提高未来CM研究的外部有效性。（中风。2008;39：3222-3230）。
Background and Purpose-Cavernous malformations of the brain (CMs) cause intracranial hemorrhage, but its reported frequency varies, partly attributable to study design. To improve the validity of future research, we aimed to develop a robust definition of CM hemorrhage.Methods-We systematically reviewed the published literature (Ovid Medline and Embase to June 1, 2007) for definitions of CM hemorrhage used in studies of the untreated clinical course of >= 20 participants with CM(s), to inform the development of a consensus statement on the clinical and imaging features of CM hemorrhage at a scientific workshop of the Angioma Alliance.Results-A systematic review of 1426 publications about CMs in humans, revealed 15 studies meeting our inclusion criteria. Although 14 (93%) studies provided a definition of CM hemorrhage, data were less complete on the confirmatory type(s) of imaging (87%), whether CM hemorrhage should be clinically symptomatic (73%), and whether hemorrhage had to extend outside the CM or not (47%). We define a CM hemorrhage as requiring acute or subacute onset symptoms (any of: headache, epileptic seizure, impaired consciousness, or new/worsened focal neurological deficit referable to the anatomic location of the CM) accompanied by radiological, pathological, surgical, or rarely only cerebrospinal fluid evidence of recent extra-or intralesional hemorrhage. The definition includes neither an increase in CM diameter without other evidence of recent hemorrhage, nor the existence of a hemosiderin halo.Conclusions-A consistent approach to clinical and brain imaging classification of CM hemorrhage will improve the external validity of future CM research. (Stroke. 2008;39:3222-3230.)