Do brainstem cavernous malformations have a higher rate of hemorrhage?

Abstract

The natural history of brainstem cavernous malformation is particularly complex. Currently, there is a wide range of reported annual rates of hemorrhage. Many studies report a significantly higher rate of hemorrhage and/or rehemorrhage in cavernous malformations located in the brainstem, but this is quite controversial. It is possible that brainstem cavernous malformations have a higher risk of hemorrhage and rehemorrhage, but reported variance in the literature may also be due to study limitations along with selection, patient and disease-specific; follow-up; and recall bias. An accurate assessment of hemorrhagic risk along with evaluation of patient and lesion-specific characteristics is critical in the decision-making process for potential intervention, as microsurgical intervention can significantly decrease the risk of future hemorrhage, but may be associated with significant complications.