Background: Clinical management of patients with brainstem cavernous malformations (BSCM) is often challenging due to the unpredictable clinical course and lack of high-quality evidence. Nevertheless, radiologic follow-up is often performed routinely. The objective of this work was to investigate whether active follow-up by serial imaging is justified and how planned imaging will impact clinical decision making in absence of clinical progression. Methods: We included all consecutive patients with BSCM treated and followed at our Department between 2006 and 2018. Results: Of 429 patients with CCM, 118 were diagnosed with BSCM (27.5%). Patients were followed for a mean of 8.1 (± 7.4 SD) years. Conservative treatment was recommended in 54 patients over the complete follow-up period, whereas 64 patients underwent surgical extirpation of BSCM. In total, 75 surgical procedures were performed. Over a period of 961 follow-up years in total, routinely performed follow-up MRI in clinically stable patients did not lead to a single indication for surgery. Conclusion: Due to the difficult-to-predict clinical course of patients with BSCM and the relatively high risk associated with surgery, routine imaging is unlikely to have any influence on surgical decision making in clinically stable patients with BSCM.

中文翻译：

---

在临床稳定的脑干海绵状畸形患者中，连续随访影像的影响有限。

背景：由于不可预测的临床过程和缺乏高质量的证据，脑干海绵状畸形（BSCM）患者的临床治疗通常具有挑战性。然而，放射学随访通常是常规进行的。这项工作的目的是调查通过连续影像学进行主动随访是否合理，以及计划的影像学将如何在缺乏临床进展的情况下影响临床决策。方法：我们纳入了2006年至2018年间在本科接受治疗并随访的所有BSCM患者。结果：在429例CCM患者中，有118例被诊断为BSCM（27.5％）。随访患者的平均时间为8.1年（±7.4 SD）。建议在整个随访期间对54例患者进行保守治疗，而对64例进行BSCM手术切除的患者进行保守治疗。总共，进行了75次外科手术。在总共961年的随访期内，对临床稳定的患者进行的常规MRI随访并未得出手术的单一指征。结论：由于BSCM患者的临床过程难以预测且手术风险较高，因此常规影像学检查不太可能对BSCM临床稳定患者的手术决策产生任何影响。