title: Stereotactic radiosurgery of brainstem cavernous malformations: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Over the last two decades, stereotactic radiosurgery (SRS) has arisen as a promising approach in the management of brainstem cavernous malformations (CMs). In the present study, the authors report a systematic review and meta-analysis of the available published data regarding the radiosurgical management of brainstem CMs.
  
  
  METHODS
  To identify eligible studies, systematic searches for brainstem CMs treated with SRS were conducted in major scientific publication databases. The search yielded 5 studies, which were included in the meta-analysis. Data from 178 patients with brainstem CMs were extracted. Hemorrhage rates before and after SRS were calculated, a meta-analysis was performed, and the risk ratio (RR) was determined.
  
  
  RESULTS
  Four studies showed a statically significant reduction in the annual hemorrhage rate after SRS. The overall RR was 0.161 (95% CI 0.052-0.493; p = 0.001), and 21 patients (11.8%) had transient or permanent neurological deficits.
  
  
  CONCLUSIONS
  The present meta-analysis for the radiosurgical management of brainstem CMs shows that SRS can decrease the rate of repeat hemorrhage and has a low rate of adverse effects compared with surgery. The authors suggest that SRS may be considered as an alternative treatment for brainstem CMs that are inoperable or have a high operative risk.
authors: Department of Neurosurgery, People's Hospital Affiliated to Jiangsu University, Zhenjiang;
authors: Xin-Yu
authors: XY
authors: Lu
authors: Hui
authors: H
authors: Sun
authors: Jian-Guo
authors: JG
authors: Xu
authors: Qiao-Yu
authors: QY
authors: Li
mesh_terms: D001933:Brain Stem / Q000601:surgery*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000601:surgery*; D006801:Humans; D016634:Radiosurgery; D013238:Stereotaxic Techniques; D016896:Treatment Outcome