Systematic review and meta-analysis on mortality and functional outcome in patients with large cerebellar infarctions treated with neurosurgery.
Myriam Perla Mazloum, Hilde Henon, Alberto Coccia et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis examined mortality and functional outcomes after neurosurgery for large cerebellar infarctions. It included 27 retrospective observational studies, with 662 neurosurgically treated patients among 1173 patients overall; no randomised trials were identified. Pooled mortality was 18% [95% CI, 13-24%]. Among survivors, 64% achieved a favorable functional outcome [95% CI, 51-77%]. Differences in study design and patient characteristics prevented meaningful comparisons between neurosurgical techniques. The authors conclude that neurosurgery may benefit patients, while emphasizing that higher-quality evidence is needed.
Key findings
- Across 662 neurosurgically treated patients, pooled mortality was 18% [95% CI, 13-24%], with I 2 58%.
- Among survivors, 64% achieved a favorable functional outcome [95% CI, 51-77%], with I 2 82%.
- All 27 included studies were retrospective and observational; no randomized clinical trial was identified.
- Study design and variation in patient characteristics precluded meaningful comparisons of outcomes by neurosurgical technique.
Why it matters
Large cerebellar infarctions can have malignant evolution, yet management recommendations are based on limited evidence. These pooled outcomes provide an estimate of mortality and functional recovery after neurosurgery, while the substantial heterogeneity and observational evidence mean they cannot establish treatment effectiveness or identify the best surgical approach.
What to keep in mind
All included studies were retrospective and observational, with no randomized trial. Heterogeneity in patient characteristics and study design limited comparisons between neurosurgical techniques.