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This prospective, population-based cohort study involving 190 symptomatic cerebral cavernous malformation (CCM) patients with a median follow-up of 16 years evaluates the long-term safety and effectiveness of CCM interventions versus conservative management. CCM intervention, primarily microsurgical resection, was associated with a higher risk of severe functional impairment or death, potentially mediated by increased rates of intracranial hemorrhage or focal neurological deficits. No significant association was observed between intervention and seizure outcomes. These results highlight the urgency for randomized controlled trials to define optimal management strategies.
