Use acupuncture to treat the patients who received the surgery of CPA tumor. Acupoints of reference: Yifeng(TE17),Tinggong(SI19),Xiaguan(ST07),Wind Pool(GB20),Outer Pass(SJ5),Union Valley(LI4),Yang Mound Spring(GB34),Leg Three Li(ST36).
Use questionnaires to evaluate.The questionnaires including House-Brackmann Grading Scale,WHOQOL-BREF Taiwan Version,Functional Assessment of Cancer Therapy: General(FACT-G),Visual Analogue Scale(VAS).

1.Use questionnaires to evaluate.The questionnaires including House-Brackmann Grading Scale,WHOQOL-BREF Taiwan Version,Functional Assessment of Cancer Therapy: General(FACT-G),Visual Analogue Scale(VAS).

Acupuncture

Tumor, Brain

Skull Base Tumor

Cerebellopontine Angle Tumor

Complication of Treatment

Quality of Life

Neuromuscular Blockade

Center for Traditional Medicine, Taipei VGH

Evaluation of Acupuncture Effects for Complications After Surgery of Cerebellopontine Angle Tumor in Skull Base

Evaluate the quality of life after acupuncture treatment, use WHOQOL-BREF Taiwan Version questionnaire. Scale: 0~100, higher scores, better life quality. Counted by each time recording and using mode conversion to get final scale.

measurement for pain,to assess the pain degree. Scale: 0~100 mm, higher scores, higher pain . Counted by each time recording.

Evaluate the quality of life for " the patients of CPA tumor in skull base " after acupuncture treatment,there are four parts,physiology,social and family, emotion,function.Scale: 0~100, higher scores, better life quality. Counted by each time recording and using mode conversion to get final scale.

measurement and evaluate the level for the patients of facial paralysis after surgery of CPA tumor in skull base.Measure the upwards and outwards movement situation of eyebrows and mouth. Each reference point scores 1 point for each 0.25 cm movement, up to a maximum of 1 cm. The scores are then added together, to give a number out of 8.After that, the scale of facial paralysis corresponding to the score was divided into five levels, with the first level being the mildest and the fifth level being the most severe.

Taipei Veterans General Hospital, Taiwan

Initial oral dose 40 mg bid, uptitrated to 80mg bid doses as low as 10 mg bid and up to 160 mg bid, 20 to 320mg daily, are acceptable according to tolerability.

Cerebral Cavernous Malformation

Patients randomized to the experimental arm will receive propranolol on top of standard recommended treatment for CCM. Initial oral dose of 40 mg bid will be uptitrated to 80 mg bid in the absence of excessive bradycardia or hypotension. Doses as low as 10 mg bid and up to 160 mg bid, 20 to 320mg daily, are acceptable according to tolerability.

Propranolol

IRCCS Casa Sollievo della Sofferenza

IRCCS Centro Neurolesi "Bonino Pulejo"

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

Fond. IRCCS Ist. Naz. Neurologico Carlo Besta

ASST Grande Ospedale Metropolitano Niguarda

Fondazione Policlinico Universitario "A. Gemelli"

Treat_CCM: Propranolol in Cerebral Cavernous Malformation

Treat_CCM Clinical Trial A Multicenter Randomized Clinical Trial on Propranolol in Cerebral Cavernous Malformation

New occurrence of clinical events CCM-related, that is intra-cerebral hemorrhage (ICH) and focal neurological deficits (FND) excluding seizures.

De novo CCM lesions depiction will be obtained on MRI QSM and Susceptibility Weighted Images (SWI) that is very sensitive to hemoglobin and iron deposition.

Global disability and health related quality of life as assessed by Beck Depression Inventory -BDI- questionnaire. BDI is made of 21 questions scored on a scale from 0 to 3, 0 representing the best condition. Final score will be the sum of all scores and will range from 0 to 63, were 0 is the best condition. SF-36 is made of 36 questions scored on a scale from 0 to 100 representing the highest level of functioning possible. Questions are aggregated in 8 dimensions of health (eg pain, phsical functioning etc.).

Location and MRI signal characteristics of CCM lesions will be assessed by 3 T brain MRI. The encephalic regions evaluated will be: cerebellum, brainstem, right/left hemisphere, right/left basal ganglia. Lesions with previous surgical treatment will be excluded from imaging analysis

Diameter will be assessed in millimeters.

Micro-hemorrhages will be assessed by magnetic susceptibility of the brain tissue, a biophysical property proportional to local iron content (quantitative susceptibility mapping, QSM). Unit of Measure of QSM is parts per million (ppm). Changes from baseline will be calculated.

Cerebral vascular permeability will be assessed after injection of gadolinium at MRI by dynamic contrast enhanced permeability (DCEP) method. Changes from baseline will be calculated.

Locking of the trial data base, completion of main analyses, and submission for publication of the main study result are expected to take at least 14 months after last patient-last-visit date.
Only clinical data relative to patients' characteristics and follow-up will be shared for each individual patient. Biohumoral and imaging data will be shared only after approval by the Steering Committee of the trial of a specific request.

Mario Negri Institute for Pharmacological Research

IFOM, The FIRC Institute of Molecular Oncology

Treat_CCM is a Prospective Randomized Open Trial with Blinded Evaluation of outcomes (PROBE).
Clinical events CCM-related (i.e. intra-cerebral hemorrhage and focal neurological deficits excluding seizures) will be blindly adjudicated by an independent Event Committee.All MRI exams will be read in a Central Laboratory by experienced neuroradiologists, unaware of patient identification and study treatment.

hemangioma/kopfschmerz

Evaluation of Acupuncture Effects for Complications After Surgery of Cerebellopontine Angle Tumor in Skull Base

Treat_CCM: Propranolol in Cerebral Cavernous Malformation

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