Solitary sporadic cerebral cavernous malformations (CCM)– Risk factors of first or recurrent symptomatic hemorrhage and associated functional impairment

Abstract Objective To quantify the risk of a first or recurrent hemorrhage and the associated functional impairment in patients with sporadic solitary cerebral cavernous malformations (CCM) and investigate the potential risk factors. Methods We undertook an observational study (n=199) of consecutive patients with the diagnosis of a single, sporadic CCM using clinical and MRI follow-up to identify prospective hemorrhage events and associated functional impairment. We calculated the annual hemorrhage risk rates, cumulative risks and performed uni- and multivariate analysis to assess outcome predictors. Results 199 adults were identified and 712.5 person-years of follow-up were analyzed. Overall annual rates of hemorrhage were 6.03%, 11.95% and 1.03% in the complete cohort, in those presenting with previous hemorrhage and in those without, respectively. The 5-year risk of hemorrhage was higher in those presenting with previous hemorrhage compared to those without (40.9% (95% CI 31.78 – 50.73) vs. 8.6% (3.97 – 16.95); p