title: A systematic review and meta-analysis of surgeries performed for treating deep-seated cerebral cavernous malformations.
abstract: OBJECTIVE
  The 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  A 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.
  
  
  CONCLUSIONS
  Our 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.
authors: a Department of Neurosurgery , HuaShan Hospital, Shanghai Medical College, Fudan University , Shanghai , China.
authors: Nidan
authors: N
authors: Qiao
authors: Zengyi
authors: Z
authors: Ma
authors: Jianping
authors: J
authors: Song
authors: Yongfei
authors: Y
authors: Wang
authors: Xuefei
authors: X
authors: Shou
authors: Xiaoluo
authors: X
authors: Zhang
authors: Ming
authors: M
authors: Shen
authors: Huijia
authors: H
authors: Qiu
authors: Zhao
authors: Z
authors: Ye
authors: Wenqiang
authors: W
authors: He
authors: Shiqi
authors: S
authors: Li
authors: Chaowei
authors: C
authors: Fu
authors: Yao
authors: Y
authors: Zhao
mesh_terms: D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*
keywords: cerebral cavernous malformations; haemorrhage; meta-analysis; surgery