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Surgical treatment of brainstem cavernous malformations: an international Delphi consensus.

Publication ,  Journal Article
Dammann, P; Abla, AA; Al-Shahi Salman, R; Andrade-Barazarte, H; Benes, V; Cenzato, M; Connolly, ES; Cornelius, JF; Couldwell, WT; Sola, RG ...
Published in: J Neurosurg
May 1, 2022

OBJECTIVE: Indication for surgery in brainstem cavernous malformations (BSCMs) is based on many case series, few comparative studies, and no randomized controlled trials. The objective of this study was to seek consensus about surgical management aspects of BSCM. METHODS: A total of 29 experts were invited to participate in a multistep Delphi consensus process on the surgical treatment of BSCM. RESULTS: Twenty-two (76%) of 29 experts participated in the consensus. Qualitative analysis (content analysis) of an initial open-ended question survey resulted in 99 statements regarding surgical treatment of BSCM. By using a multistep survey with 100% participation in each round, consensus was reached on 52 (53%) of 99 statements. These were grouped into 4 categories: 1) definitions and reporting standards (7/14, 50%); 2) general and patient-related aspects (11/16, 69%); 3) anatomical-, timing of surgery-, and BSCM-related aspects (22/37, 59%); and 4) clinical situation-based decision-making (12/32, 38%). Among other things, a consensus was reached for surgical timing, handling of associated developmental venous anomalies, handling of postoperative BSCM remnants, assessment of specific anatomical BSCM localizations, and treatment decisions in typical clinical BSCM scenarios. CONCLUSIONS: A summary of typical clinical scenarios and a catalog of various BSCM- and patient-related aspects that influence the surgical treatment decision have been defined, rated, and interpreted.

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Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

May 1, 2022

Volume

136

Issue

5

Start / End Page

1220 / 1230

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

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Dammann, P., Abla, A. A., Al-Shahi Salman, R., Andrade-Barazarte, H., Benes, V., Cenzato, M., … Sure, U. (2022). Surgical treatment of brainstem cavernous malformations: an international Delphi consensus. J Neurosurg, 136(5), 1220–1230. https://doi.org/10.3171/2021.3.JNS2156
Dammann, Philipp, Adib A. Abla, Rustam Al-Shahi Salman, Hugo Andrade-Barazarte, Vladimir Benes, Marco Cenzato, E Sander Connolly, et al. “Surgical treatment of brainstem cavernous malformations: an international Delphi consensus.J Neurosurg 136, no. 5 (May 1, 2022): 1220–30. https://doi.org/10.3171/2021.3.JNS2156.
Dammann P, Abla AA, Al-Shahi Salman R, Andrade-Barazarte H, Benes V, Cenzato M, et al. Surgical treatment of brainstem cavernous malformations: an international Delphi consensus. J Neurosurg. 2022 May 1;136(5):1220–30.
Dammann, Philipp, et al. “Surgical treatment of brainstem cavernous malformations: an international Delphi consensus.J Neurosurg, vol. 136, no. 5, May 2022, pp. 1220–30. Pubmed, doi:10.3171/2021.3.JNS2156.
Dammann P, Abla AA, Al-Shahi Salman R, Andrade-Barazarte H, Benes V, Cenzato M, Connolly ES, Cornelius JF, Couldwell WT, Sola RG, Gomez-Paz S, Hauck E, Hernesniemi J, Kivelev J, Lanzino G, Macdonald RL, Morcos JJ, Ogilvy CS, Steiger H-J, Steinberg GK, Santos AN, Rauschenbach L, Darkwah Oppong M, Schmidt B, Spetzler RF, Schaller K, Lawton MT, Sure U. Surgical treatment of brainstem cavernous malformations: an international Delphi consensus. J Neurosurg. 2022 May 1;136(5):1220–1230.

Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

May 1, 2022

Volume

136

Issue

5

Start / End Page

1220 / 1230

Location

United States

Related Subject Headings

  • Neurology & Neurosurgery
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences