Management of deep-seated cerebral cavernous malformations (CCMs) remains challenging given their location in difficult-to-access, eloquent brain regions. Further adding to their management complexity is the inability to accurately predict the biological aggressiveness of individual lesions. Annual rate of a first symptomatic hemorrhage is approximately 2% to 3% per year; however, rehemorrhage rates, although higher, range from 4.5% through 30% to 40% per lesion, per year, with the highest risk in the first 2 to 3 yr after the initial bleed.¹ Given these challenges, current management typically involves initial observation, with surgical consideration only after rehemorrhage or progression of neurological deficits, when risks of the cavernoma's natural history are deemed higher than risks of the surgical approach.

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评论：磁共振成像引导立体定向激光消融术治疗深部脑海绵状血管瘤的可行性和发病率：附4例报告

鉴于深部脑海绵状血管畸形 (CCM) 位于难以进入的、雄辩的大脑区域，其管理仍然具有挑战性。进一步增加其管理复杂性的是无法准确预测单个病变的生物学侵袭性。首次症状性出血的年发生率约为每年 2% 至 3%；然而，再出血率虽然较高，但每个病变每年的范围为 4.5% 至 30% 至 40%，在初次出血后的前 2 至 3 年内风险最高。¹鉴于这些挑战，目前的管理通常涉及初步观察，只有在再出血或神经功能缺损进展后才考虑手术，此时海绵状血管瘤自然病程的风险被认为高于手术入路的风险。