Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation

Background and Purpose: The morbidity from spontaneous hemorrhage of untreated brain arteriovenous malformations (AVM) is not well described. Methods: The 241 consecutive AVM patients (mean age 3716 years, 52% women) from the prospective Columbia AVM Databank initially presenting with hemorrhage...

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Other Authors: Choi, Jae
Format: Article
Published: American Heart Association 2006
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Online Access:https://eprints.nottingham.ac.uk/502/
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author_facet Choi, Jae
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description Background and Purpose: The morbidity from spontaneous hemorrhage of untreated brain arteriovenous malformations (AVM) is not well described. Methods: The 241 consecutive AVM patients (mean age 3716 years, 52% women) from the prospective Columbia AVM Databank initially presenting with hemorrhage were evaluated using the Rankin Scale (RS) and the National Institute of Health Stroke Scale (NIHSS). From the 241 AVM patients, 29 (12%) had subsequent intracranial hemorrhage during follow-up. For further comparisons, 84 non-AVM patients with intracerebral hemorrhage from the Northern Manhattan Study (NOMAS) served as a control group. Results: In 241 AVM patients presenting with hemorrhage the median RS was 2 and the median NIHSS was 1 (49% RS 0 to 1, 61% NIHSS 2). The median time between hemorrhage and clinical evaluation was 11 days (mean 219 days). Recurrent AVM hemorrhage during follow-up resulted in no significant increase in morbidity (median RS 2, P0.004; median NIHSS 3, P0.322; time between hemorrhage and study evaluation: median 55 days, mean 657 days). Among AVM-hemorrhage subtypes, parenchymatous AVM hemorrhage was associated with higher stroke morbidity (odds ratio, 2.9; 95% CI, 1.5 to 5.8 for NIHSS 2) than nonparenchymatous hemorrhages. Parenchymatous AVM hemorrhage had a significantly better outcome (median NIHSS 1) than non-AVM related hemorrhage (median NIHSS 12; P0.0001). Conclusions: Hemorrhage, either at initial presentation or during follow-up of untreated AVM patients appears to carry
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spelling nottingham-5022020-05-04T20:29:41Z https://eprints.nottingham.ac.uk/502/ Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation Background and Purpose: The morbidity from spontaneous hemorrhage of untreated brain arteriovenous malformations (AVM) is not well described. Methods: The 241 consecutive AVM patients (mean age 3716 years, 52% women) from the prospective Columbia AVM Databank initially presenting with hemorrhage were evaluated using the Rankin Scale (RS) and the National Institute of Health Stroke Scale (NIHSS). From the 241 AVM patients, 29 (12%) had subsequent intracranial hemorrhage during follow-up. For further comparisons, 84 non-AVM patients with intracerebral hemorrhage from the Northern Manhattan Study (NOMAS) served as a control group. Results: In 241 AVM patients presenting with hemorrhage the median RS was 2 and the median NIHSS was 1 (49% RS 0 to 1, 61% NIHSS 2). The median time between hemorrhage and clinical evaluation was 11 days (mean 219 days). Recurrent AVM hemorrhage during follow-up resulted in no significant increase in morbidity (median RS 2, P0.004; median NIHSS 3, P0.322; time between hemorrhage and study evaluation: median 55 days, mean 657 days). Among AVM-hemorrhage subtypes, parenchymatous AVM hemorrhage was associated with higher stroke morbidity (odds ratio, 2.9; 95% CI, 1.5 to 5.8 for NIHSS 2) than nonparenchymatous hemorrhages. Parenchymatous AVM hemorrhage had a significantly better outcome (median NIHSS 1) than non-AVM related hemorrhage (median NIHSS 12; P0.0001). Conclusions: Hemorrhage, either at initial presentation or during follow-up of untreated AVM patients appears to carry American Heart Association Choi, Jae Mast, Henning Sciacca, Robert Hartmann, Andreas Khaw, Alexander Mohr, Jay Sacco, Ralph Stapf, Christian 2006 Article PeerReviewed UNSPECIFIED (2006) Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation. Stroke, 37 . pp. 1243-1247. cerebral arteriovenous malformations intracerebral hemorrhage intracranial hemorrhage outcome subarachnoid hemorrhage
spellingShingle cerebral arteriovenous malformations intracerebral hemorrhage intracranial hemorrhage outcome subarachnoid hemorrhage
Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
title Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
title_full Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
title_fullStr Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
title_full_unstemmed Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
title_short Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
title_sort clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation
topic cerebral arteriovenous malformations intracerebral hemorrhage intracranial hemorrhage outcome subarachnoid hemorrhage
url https://eprints.nottingham.ac.uk/502/