Treatment of Cerebral Cavernous Malformations Presenting With Seizures: A Systematic Review and Meta-Analysis.
Treatment of Cerebral Cavernous Malformations Presenting With Seizures: A Systematic Review and Meta-Analysis.
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伴有癫痫发作的脑海绵状血管瘤的治疗：系统评价和荟萃分析
DOI：
10.3389/fneur.2020.590589
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发表时间：
2020
影响因子：
3.4
通讯作者：
Jiang X
中科院分区：
文献类型：
--
作者：
Gao X;Yue K;Sun J;Cao Y;Zhao B;Zhang H;Dai S;Zhang L;Luo P;Jiang X
背景：伴有癫痫发作的脑海绵状血管瘤（CCM）可以通过神经外科或放射外科治疗，但理想的治疗方法仍不清楚。目前，还没有足够的随机对照试验来比较致痫性 CCM 的手术治疗和放疗。因此，我们对已发表文献中的可用数据进行了系统回顾和荟萃分析，以比较神经外科手术和放射外科手术治疗致痫性脑海绵状血管瘤的有效性和安全性。方法：我们全面检索了 Ovid MEDLINE、Web of Science、PubMed、中国生物医药和中国国家知识基础设施数据库，查找 1994 年 1 月至 2019 年 10 月期间发表的研究。检索术语如下：“癫痫”、“癫痫发作”、“脑海绵状血管瘤”、“脑海绵状血管瘤”、“脑海绵状血管瘤”、 “血管瘤、海绵状血管瘤、中枢神经系统。”两名研究人员独立提取数据并审阅所有文章。我们比较了两种治疗方法的优点和缺点。结果：我们的分析中总共纳入了 45 项研究。总体而言，神经外科手术的癫痫发作控制率为 79%（95% CI：75-83%），放射外科手术的癫痫发作控制率为 49%（95% CI：38-59%）。在神经外科研究中，4.4% 的患者出现永久性发病，而放射治疗研究中没有患者出现永久性发病。此外，亚组分析结果表明，种族、CCM 位置和平均病变数量可能是影响治疗后癫痫发作结果的重要因素。结论：神经外科手术后的癫痫控制率高于放射外科手术后的癫痫控制率，但神经外科手术的永久发病率也相对较高。
Background: Cerebral cavernous malformations (CCMs) presenting with seizures can be treated with neurosurgery or radiosurgery, but the ideal treatment remains unclear. Currently, there is no adequate randomized controlled trial comparing surgical treatment and radiotherapy for epileptogenic CCMs. Therefore, we conducted a systematic review and meta-analysis of available data from published literature to compare the efficacy and safety of neurosurgery and radiosurgery for epileptogenic CCMs. Methods: We performed a comprehensive search of the Ovid MEDLINE, Web of Science, PubMed, China Biological Medicine and China National Knowledge Infrastructure databases for studies published between January 1994 and October 2019. The search terms were as follows: “epilepsy,” “seizures,” “brain cavernous hemangioma,” “cerebral cavernous malformation,” “cerebral cavernous hemangioma,” “hemangioma, cavernous, central nervous system.” Two researchers independently extracted the data and reviewed all the articles. We compared the advantages and disadvantages of the two treatments. Results: A total of 45 studies were included in our analysis. Overall, the seizure control rate was 79% (95% CI: 75–83%) for neurosurgery and 49% (95% CI: 38–59%) for radiosurgery. In the neurosurgery studies, 4.4% of patients experienced permanent morbidity, while no patients in the radiotherapy studies had permanent morbidity. In addition, the results of subgroup analysis showed that ethnicity, CCMs location and average lesion number are likely significant factors influencing the seizure outcome following treatment. Conclusions: The epilepsy control rate after neurosurgery was higher than that after radiosurgery, but neurosurgery also had a relatively higher rate of permanent morbidity.
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影响因子：
0.7
作者：
Amin-Hanjani, S;Robertson, R;Scott, RM
通讯作者：
Scott, RM
181 例幕上脑海绵状血管瘤相关癫痫患者手术治疗的长期结果。
影响因子：
2
作者：
He, Kangmin;Jiang, Shize;Mao, Ying
通讯作者：
Mao, Ying
影响因子：
3
作者：
Hammen, T.;Romstoeck, J.;Stefan, H.
通讯作者：
Stefan, H.
影响因子：
1.7
作者：
Bartolomei, F;Régis, J;Pendl, G
通讯作者：
Pendl, G
影响因子：
5.6
作者：
Cascino, Gregory D.
通讯作者：
Cascino, Gregory D.