Brain, Vol. 124, No. 10, 1900-1926,
October 2001
© 2001 Oxford University Press
Invited Review |
A systematic review of the frequency and prognosis of arteriovenous malformations of the brain in adults
University Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK
Correspondence to:
Dr Rustam Al-Shahi, Department of Clinical Neurosciences, Bramwell Dott Building, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK E-mail: ras{at}skull.dcn.ed.ac.uk
By systematically reviewing the literature, we have found that there is very little information about the frequency and clinical course of arteriovenous malformations (AVMs) of the brain in adults because the methods of most studies have been flawed, and AVMs tend to be treated once they are discovered. The incidence of AVMs is ~1 per 100 000 per year in unselected populations, and the point prevalence in adults is ~18 per 100 000. AVMs account for between 1 and 2% of all strokes, 3% of strokes in young adults, 9% of subarachnoid haemorrhages and, of all primary intracerebral haemorrhages, they are responsible for 4% overall, but for as much as one-third in young adults. AVMs are far less common causes of first presentations with unprovoked seizures (1%), and of people presenting with headaches in the absence of neurological signs (0.3%). At the time of detection, at least 15% of people affected by AVMs are asymptomatic, about one-fifth present with seizures and for approximately two-thirds of them the dominant mode of presentation is with intracranial haemorrhage. The limited high quality data available on prognosis suggest that long-term crude annual case fatality is 1–1.5%, the crude annual risk of first occurrence of haemorrhage from an unruptured AVM is ~2%, but the risk of recurrent haemorrhage may be as high as 18% in the first year, with uncertainty about the risk thereafter. For untreated AVMs, the annual risk of developing de novo seizures is 1%. There is a pressing need for large, prospective studies of the frequency and clinical course of AVMs in well-defined, stable populations, taking account of their prognostic heterogeneity.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C Cordonnier, R A.-S. Salman, J J Bhattacharya, C E Counsell, V Papanastassiou, V Ritchie, R C Roberts, R J Sellar, C Warlow, and SIVMS Collaborators Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages: prospective, population-based study J. Neurol. Neurosurg. Psychiatry, January 1, 2008; 79(1): 47 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Friedlander Arteriovenous Malformations of the Brain N. Engl. J. Med., June 28, 2007; 356(26): 2704 - 2712. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Stapf, H. Mast, R. R. Sciacca, J. H. Choi, A. V. Khaw, E. S. Connolly, J. Pile-Spellman, and J. P. Mohr Predictors of hemorrhage in patients with untreated brain arteriovenous malformation Neurology, May 9, 2006; 66(9): 1350 - 1355. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Al-Shahi, C. Vousden, C. Warlow, and for the Scottish Intracranial Vascular Malformatio Bias from requiring explicit consent from all participants in observational research: prospective, population based study BMJ, October 22, 2005; 331(7522): 942. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Al-Shahi and C Warlow Arteriovenous malformations of the brain: ready to randomise? J. Neurol. Neurosurg. Psychiatry, October 1, 2005; 76(10): 1327 - 1329. [Full Text] [PDF]
|
|
|
|
|
|
L K Tsai, J S Jeng, H M Liu, H J Wang, and P K Yip Intracranial dural arteriovenous fistulas with or without cerebral sinus thrombosis: analysis of 69 patients J. Neurol. Neurosurg. Psychiatry, November 1, 2004; 75(11): 1639 - 1641. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. X. Halim, S. C. Johnston, V. Singh, C. E. McCulloch, J. P. Bennett, A. S. Achrol, S. Sidney, and W. L. Young Longitudinal Risk of Intracranial Hemorrhage in Patients With Arteriovenous Malformation of the Brain Within a Defined Population Stroke, July 1, 2004; 35(7): 1697 - 1702. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L.-K. Tsai, J.-S. Jeng, H.-J. Wang, P.-K. Yip, and H.-M. Liu Diagnosis of Intracranial Dural Arteriovenous Fistulas by Carotid Duplex Sonography J. Ultrasound Med., June 1, 2004; 23(6): 785 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stapf, A.V. Khaw, R.R. Sciacca, C. Hofmeister, H.C. Schumacher, J. Pile-Spellman, H. Mast, J.P. Mohr, and A. Hartmann Effect of Age on Clinical and Morphological Characteristics in Patients With Brain Arteriovenous Malformation Stroke, November 1, 2003; 34(11): 2664 - 2669. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Al-Shahi, J. J. Bhattacharya, D. G. Currie, V. Papanastassiou, V. Ritchie, R. C. Roberts, R. J. Sellar, and C. P. Warlow Scottish Intracranial Vascular Malformation Study (SIVMS): Evaluation of Methods, ICD-10 Coding, and Potential Sources of Bias in a Prospective, Population-Based Cohort Stroke, May 1, 2003; 34(5): 1156 - 1162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R Al-Shahi, J S Y Fang, S C Lewis, and C P Warlow Prevalence of adults with brain arteriovenous malformations: a community based study in Scotland using capture-recapture analysis J. Neurol. Neurosurg. Psychiatry, November 1, 2002; 73(5): 547 - 551. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Al-Shahi, N. Pal, S. C. Lewis, J. J. Bhattacharya, R. J. Sellar, C. P. Warlow, A. X. Halim, W. L. Young, and S. C. Johnston Observer Agreement in the Angiographic Assessment of Arteriovenous Malformations of the Brain * Editorial Comment Stroke, June 1, 2002; 33(6): 1501 - 1508. [Abstract] [Full Text] [PDF]
|
|