Evidence map›Paper›PMID 28387823›Full record

SynthesisNeurosurgery2017

Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel.

Amy Akers, Rustam Al-Shahi Salman, Issam A Awad, Kristen Dahlem, Kelly Flemming, Blaine Hart, Helen Kim, Ignacio Jusue-Torres, Douglas Kondziolka, Cornelia Lee and 6 more

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Neurosurgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01764529 (Modifiers of Disease Severity and Progression in Cerebral Cavernous Malformations), which is not on this map. Cited by 215 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
215citing papers in PubMed, 7 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.

NCT01764529 completednot on this map

Modifiers of Disease Severity and Progression in Cerebral Cavernous Malformations

Typeobservational_patient_registrySponsorUniversity of California, San FranciscoRan2010 to 2025Enrolled789ConditionsCavernous Angioma, Familial, Cerebral Cavernous Malformations, Cerebral Cavernous Hemangioma
3 · Its place in the literature

Who cites it

215 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  20. iScience · 2026
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155 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

16 authors.

Amy AkersAngioma Alliance Norfolk, Virginia.
Rustam Al-Shahi SalmanCentre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
Issam A AwadNeurovascular Surgery Program, Section of Neurosurgery, University of Chicago Medicine and Biological Sciences, Chicago, Illinois.
Kristen DahlemAngioma Alliance Norfolk, Virginia.
Kelly FlemmingDepartment of Neurology, Mayo Clinic, Rochester, Minnesota.
Blaine HartDepartment of Radiology, University of New Mexico, Albuquerque, New Mexico.
Helen KimDepartment of Anesthesia and Perioperative Care, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California.
Ignacio Jusue-TorresDepartment of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland.
Douglas KondziolkaDepartments of Neurosurgery and Radiation Oncology, NYU Langone Medical Center, New York City, New York.
Cornelia LeeAngioma Alliance Norfolk, Virginia.
Leslie MorrisonDepartments of Neurology and Pediatrics, University of New Mexico, Albuquerque, New Mexico.
Daniele RigamontiDepartment of Neurosurgery, Johns Hopkins Medicine, Baltimore, Maryland.
Tania RebeizNeurovascular Surgery Program, Section of Neurosurgery, University of Chicago Medicine and Biological Sciences, Chicago, Illinois.
Elisabeth Tournier-LasserveDepartment of Genetics, INSERM UMR 1161, Paris, France.
Darrel WaggonerDepartment of Human Genetics and Pediatrics, University of Chicago Medicine and Biological Sciences, Chicago, Illinois.
Kevin WhiteheadDepartment of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah.

Funding

Medical Research Council G1002605Medical Research Council G108/613
6 · The paper itself

Abstract

backgroundDespite many publications about cerebral cavernous malformations (CCMs), controversy remains regarding diagnostic and management strategies.

objectiveTo develop guidelines for CCM management.

methodsThe Angioma Alliance ( www.angioma.org ), the patient support group in the United States advocating on behalf of patients and research in CCM, convened a multidisciplinary writing group comprising expert CCM clinicians to help summarize the existing literature related to the clinical care of CCM, focusing on 5 topics: (1) epidemiology and natural history, (2) genetic testing and counseling, (3) diagnostic criteria and radiology standards, (4) neurosurgical considerations, and (5) neurological considerations. The group reviewed literature, rated evidence, developed recommendations, and established consensus, controversies, and knowledge gaps according to a prespecified protocol.

resultsOf 1270 publications published between January 1, 1983 and September 31, 2014, we selected 98 based on methodological criteria, and identified 38 additional recent or relevant publications. Topic authors used these publications to summarize current knowledge and arrive at 23 consensus management recommendations, which we rated by class (size of effect) and level (estimate of certainty) according to the American Heart Association/American Stroke Association criteria. No recommendation was level A (because of the absence of randomized controlled trials), 11 (48%) were level B, and 12 (52%) were level C. Recommendations were class I in 8 (35%), class II in 10 (43%), and class III in 5 (22%).

conclusionCurrent evidence supports recommendations for the management of CCM, but their generally low levels and classes mandate further research to better inform clinical practice and update these recommendations. The complete recommendations document, including the criteria for selecting reference citations, a more detailed justification of the respective recommendations, and a summary of controversies and knowledge gaps, was similarly peer reviewed and is available on line www.angioma.org/CCMGuidelines .

Indexed as

ConsensusAdvisory CommitteesCentral Nervous System NeoplasmsDisease ManagementExpert TestimonyHemangioma, CavernousHemangioma, Cavernous, Central Nervous SystemHumansPhysical Therapy ModalitiesPractice Guidelines as TopicStrokeUnited StatesAngiomaCavernousGuidelinesMalformationRecommendations

Identifiers

PMID28387823
PMCPMC5808153

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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.