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Surgical treatment of brainstem cavernous malformations: an international Delphi consensus

Publication at First Faculty of Medicine |
2022

Abstract

Twenty-two (76%) of 29 experts participated in the consensus. Qualitative analysis (content analysis) of an initial open-ended question survey resulted in 99 statements regarding surgical treatment of BSCM. By using a multistep survey with 100% participation in each round, consensus was reached on 52 (53%) of 99 statements. These were grouped into 4 categories:

1) definitions and reporting standards (7/14, 50%);

2) general and patient-related aspects (11/16, 69%);

3) anatomical-, timing of surgery-, and BSCM-related aspects (22/37, 59%); and

4) clinical situation-based decision-making (12/32, 38%). Among other things, a consensus was reached for surgical timing, handling of associated developmental venous anomalies, handling of postoperative BSCM remnants, assessment of specific anatomical BSCM localizations, and treatment decisions in typical clinical BSCM scenarios.Conclusions: A summary of typical clinical scenarios and a catalog of various BSCM- and patient-related aspects that influence the surgical treatment decision have been defined, rated, and interpreted.