Risk of spontaneous haemorrhage after diagnosis of cerebral arteriovenous malformation

Self Cite

127

Background: Brain arteriovenous malformations (AVMs) represent a potential source of intracranial hemorrhage, especially in young adults, but prospective population-based incidence data on AVM hemorrhage are lacking. We investigated the incidence of first-ever AVM hemorrhage in adults based on population data from the Northern Manhattan Stroke Study (NOMASS). Methods: NOMASS is a prospective, population-based, stroke incidence survey collecting all hospitalized and nonhospitalized cases with first-ever (incident) stroke over the age of 20 in a ZIP code-defined area. All patients undergo CT and/or MR brain imaging and clinical data are systematically collected from the medical records. For this study, data on all cases with incident intracranial hemorrhage, i.e. any intracerebral, intraventricular and/or subarachnoid hemorrhage, occurring between July 1, 1993 and June 30, 1997 were used. Patients with intracranial hemorrhage due to trauma, tumor or intracranial vascular malformations other than a previously unknown AVM were excluded from the study. Results: Of the 207 patients diagnosed with a first-ever intracranial hemorrhage, 3 cases (1.4%) with an underlying brain AVM were identified. The crude incidence rate for first-ever AVM hemorrhage in our adult population was 0.55 per 100,000 person-years (95% confidence interval 0.11–1.61). Conclusions: Our results support prior findings from retrospective surveys. Population-based studies providing a prospective design for AVM detection and diagnosis are needed to confirm the data.

Section: Methodsmentioning

confidence: 99%

Incidence of Adult Brain Arteriovenous Malformation Hemorrhage in a Prospective Population-Based Stroke Survey

Stapf

Labovitz

Sciacca³

et al. 2002

Self Cite

127

“…Approximately half of all cerebral AVMs present with a haemorrhage [142]. The long-term risk of rebleeding was found to be as high as 18% in the first year after the initial haemorrhage [142, 143].…”

Section: Specific Treatmentmentioning

confidence: 99%

“…The long-term risk of rebleeding was found to be as high as 18% in the first year after the initial haemorrhage [142, 143]. However, the immediate short-term risk of bleeding may be relatively low.…”

Section: Specific Treatmentmentioning

confidence: 99%

Recommendations for the Management of Intracranial Haemorrhage – Part I: Spontaneous Intracerebral Haemorrhage

Takahashi¹,

Ohnuki²,

Ide³

et al. 2006

363

“…Intracerebral hemorrhage is the most common presentation, occurring in 50–65% of symptomatic AVMs [7, 8]. The risk of death from AVM-related hemorrhage has been estimated at 10–15% with an associated permanent disability of 10–50% [9].…”

Section: Introductionmentioning

confidence: 99%

Distinguishing Intracerebral Hemorrhages Caused by Arteriovenous Malformations

Johnston²,

Young

et al. 2003

Background: There is a shortage of data addressing the clinical characteristics of patients with arteriovenous malformations (AVMs) who present with intracerebral hemorrhages (ICH). Methods: A retrospective cohort study of members of a large, pre-paid health care program was conducted to identify factors that distinguish ICH secondary to cerebral AVMs from all other causes. Univariate and multivariate analysis was performed using Student’s t test, Wilcoxon rank-sum test, and logistic regression. Results: Patients with an underlying AVM were younger and more likely to be female, non-smokers with lower blood pressures, lower cholesterol, and lower white blood cell counts on presentation. Conclusions: These clinical characteristics may be useful in defining potential risk factors in future prospective studies as well as targeting candidates for additional imaging studies after ICH with no apparent etiology.