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Cerebral cavernous malformation (CCM) is the main cause of spontaneous intracerebral hemorrhage (ICH) in pediatric patients, and up to 25% of CCM affects individuals ≤18 years of age
.
Similar to adults, symptomatic CCM in children is mainly manifested as headache,Epileptic seizures or focal neurological deficits caused by acute ICH
childepilepsy
In addition, it is believed that children’s CCM has a higher risk of bleeding than adult downloads.
It is estimated that the 5-year cumulative risk of symptomatic ICH is ≈20%
.
This risk may be further influenced by factors such as gender, CCM location, and previous ICH history
Therefore, children are usually treated in accordance with adult guidelines, although it is unclear whether this inference is appropriate
.
A deeper understanding of the pathophysiology of CCM in the pediatric population will have a significant impact on current treatment strategies
In this way, Alejandro N.
Santos and others at the University Hospital Essen in Germany analyzed the natural course of CCM in young patients over a 5-year period
.
Their institutional database screened CCM patients who received treatment from 2003 to 2020
.
Patients who were ≤18 years old, had a complete magnetic resonance imaging data set, clinical baseline characteristics, and ≥1 follow-up examination were included
diagnosis
They analyzed 129 pediatric patients with CCM
.
Univariate logistic regression to determine brain stem CCM (odds, 3.
Cox regression analysis identified ICH as a manifestation (HR=14.
01 [95% CI, 1.
80-110.
39], P=0.
012) as an independent predictor of rebleeding during the 5-year follow-up period
.
The 5-year cumulative risk of (re)bleeding for the entire cohort was 15.
The important significance of this study lies in the discovery that brainstem CCM and pediatric patients with a family history of CCM have a higher risk of ICH as a manifestation
.
During the 5-year follow-up period without treatment, they showed a similar risk of (re)bleeding compared to adult patients
Brainstem CCM and pediatric patients with a family history of CCM have a higher risk of using ICH as a manifestation
Original source:
Santos AN, Rauschenbach L, Saban D, et al.
Natural Course of Cerebral Cavernous Malformations in Children: A Five-Year Follow-Up Study.
Stroke.
Natural Course of Cerebral Cavernous Malformations in Children: A Five-Year Follow-Up Study.
Stroke.
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