• Nidan Qiao, Zengyi Ma, Jianping Song, Yongfei Wang, Xuefei Shou, Xiaoluo Zhang, Ming Shen, Huijia Qiu, Zhao Ye, Wenqiang He, Shiqi Li, Chaowei Fu, and Yao Zhao.
• a Department of Neurosurgery , HuaShan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.
• Br J Neurosurg. 2015 Jan 1; 29 (4): 493-9.

ObjectiveThe clinical benefit of surgery for treatment of deep-seated cerebral cavernous malformations (CCMs) is still a matter of debate. Although the surgical removal of CCMs is widely accepted, the benefits of reducing the rate of haemorrhage must be balanced against the risk of peri-operative morbidity. Here, we provide a systematic review and meta-analysis of the clinical benefits of surgery for treating deeply localised CCMs.MethodsA comprehensive search of PubMed and Embase was conducted to identify relevant studies. The rate and a 95% confidence interval (CI) were used to measure the risk of haemorrhage and adverse outcomes.ResultsA total of 34 cohort studies reporting surgeries on CCMs were included in our analysis. Overall, the average post-surgical haemorrhage rate was 1.0% (95% CI: 0.7-1.4%). Nine per cent (95% CI: 6.9-11.3%) of the patients developed adverse events at follow-up following the surgical resection of deep-seated CCMs. The percentage of transient neural defects following surgical resection was 34.6% (95% CI: 29.4-39.9%). The proportions of transient focal neurological defect before and after the year 2006 were 44.9% (95% CI: 34.1-55.8%) and 30.3% (95% CI: 25.1-35.9%), respectively.ConclusionsOur meta-analysis demonstrates post-surgical haemorrhage rate and complications related to surgeries on deep-seated CCMs. The post-surgical haemorrhage rate was low with a relatively high rate of post-surgical complications.

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