Evidence map›Paper›PMID 27164680›Full record

SynthesisNeurology2016

Natural history of cavernous malformation: Systematic review and meta-analysis of 25 studies.

Shervin Taslimi, Amirhossein Modabbernia, Sepideh Amin-Hanjani, Fred G Barker, R Loch Macdonald

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
72citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

72 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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12 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shervin TaslimiFrom the Division of Neurosurgery (S.T.), University of Toronto, Canada; Department of Psychiatry (A.M.), Icahn School of Medicine, Mount Sinai Hospital, New York, NY; Department of Neurosurgery (S.A.-H.), University of Illinois at Chicago; Neurosurgical Service (F.G.B.), Massachusetts General Hospital, Harvard Medical School, Boston; Division of Neurosurgery (R.L.M.), St. Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre for Biomedical Science; and the Department of Surgery (R.L.M.), Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Canada.
Amirhossein ModabberniaFrom the Division of Neurosurgery (S.T.), University of Toronto, Canada; Department of Psychiatry (A.M.), Icahn School of Medicine, Mount Sinai Hospital, New York, NY; Department of Neurosurgery (S.A.-H.), University of Illinois at Chicago; Neurosurgical Service (F.G.B.), Massachusetts General Hospital, Harvard Medical School, Boston; Division of Neurosurgery (R.L.M.), St. Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre for Biomedical Science; and the Department of Surgery (R.L.M.), Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Canada.
Sepideh Amin-HanjaniFrom the Division of Neurosurgery (S.T.), University of Toronto, Canada; Department of Psychiatry (A.M.), Icahn School of Medicine, Mount Sinai Hospital, New York, NY; Department of Neurosurgery (S.A.-H.), University of Illinois at Chicago; Neurosurgical Service (F.G.B.), Massachusetts General Hospital, Harvard Medical School, Boston; Division of Neurosurgery (R.L.M.), St. Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre for Biomedical Science; and the Department of Surgery (R.L.M.), Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Canada.
Fred G BarkerFrom the Division of Neurosurgery (S.T.), University of Toronto, Canada; Department of Psychiatry (A.M.), Icahn School of Medicine, Mount Sinai Hospital, New York, NY; Department of Neurosurgery (S.A.-H.), University of Illinois at Chicago; Neurosurgical Service (F.G.B.), Massachusetts General Hospital, Harvard Medical School, Boston; Division of Neurosurgery (R.L.M.), St. Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre for Biomedical Science; and the Department of Surgery (R.L.M.), Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Canada.
R Loch MacdonaldFrom the Division of Neurosurgery (S.T.), University of Toronto, Canada; Department of Psychiatry (A.M.), Icahn School of Medicine, Mount Sinai Hospital, New York, NY; Department of Neurosurgery (S.A.-H.), University of Illinois at Chicago; Neurosurgical Service (F.G.B.), Massachusetts General Hospital, Harvard Medical School, Boston; Division of Neurosurgery (R.L.M.), St. Michael's Hospital, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre for Biomedical Science; and the Department of Surgery (R.L.M.), Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Canada. macdonaldlo@smh.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe pooled the results of studies on natural history of cavernous malformations (CM) to calculate point estimates and investigate main sources of heterogeneity.

methodsWe searched MEDLINE, EMBASE, and ISI Web of Science for relevant studies published before May 2015. We used fixed or random effects models and meta-regression to pool the data.

resultsTwenty-five studies were entered into the meta-analysis (90-1,295 patients depending on the analysis). Bleeding was defined as symptomatic hemorrhage plus radiologic evidence of hemorrhage. Sources of heterogeneity were identified as mixture of hemorrhage and rehemorrhage, mixture of rehemorrhage before and after 2 years of first bleeding, brainstem vs other locations, and calculation method. The rehemorrhage rate was higher than the hemorrhage rate (incidence rate ratio 16.5, p < 0.001, 95% confidence interval [CI] 9.7-28.0). Rehemorrhage within 2 years of the first hemorrhage was higher than after that (incidence rate ratio 1.8, p = 0.042, 95% CI 1.5-2.0). In two metaregression models, rough estimate of the annual incidence rate of hemorrhage was 0.3% (95% CI 0.1%-0.5%) and 2.8% (2.5%-3.3%) per person year in nonbrainstem and brainstem lesions and rough estimate of annual rehemorrhage rate per person year was 6.3% (3%-13.2%) and 32.3% (19.8%-52.7%) in nonbrainstem and brainstem lesions. Median time to rehemorrhage was 10.5 months. Posthemorrhage full recovery was 38.8%/person-year (28.7%-48.8%). Posthemorrhage full recovery or minimal disability was 79.5%/person-year (74.3%-84.8%). Mortality after bleeding was 2.2%.

conclusionsThe incidence of symptomatic hemorrhage or rehemorrhage is higher in brainstem lesions. First symptomatic hemorrhage increases the chance of symptomatic rehemorrhage, which decreases after 2 years.

Indexed as

Brain StemCentral Nervous System NeoplasmsCerebral HemorrhageHemangioma, Cavernous, Central Nervous SystemHumansRecurrence

Identifiers

PMID27164680
PMCPMC4887121

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.