(Stroke. 2000;31:1307.)
© 2000 American Heart Association, Inc.
Original Contributions |
Demographic, Morphological, and Clinical Characteristics of 1289 Patients With Brain Arteriovenous Malformation
From Berufsgenossenschaftliche Kliniken der Stadt Halle (C.H., H.M., J.M.), Bergmannstrost, Halle/Saale, Germany; Universitätsklinikum Benjamin Franklin (C.S., A.H., U.M., H.M.), Freie Universität Berlin, Berlin, Germany; Stroke Center/The Neurological Institute (C.S., R.R.S., J.P.M., H.M.), Columbia University, New York, NY; Toronto Hospital (K.T.), University of Toronto, Toronto, Canada; and Hôpital de Bicêtre (P.L.), Université Paris XI, Le Kremlin Bicêtre, France.
Correspondence to H. Mast, MD, Stroke Center/The Neurological Institute, 710 West 168th St, New York, NY 10032. E-mail hm56{at}columbia.edu
Background and Purpose—The purpose of this study was to assess demographic, clinical, and morphological characteristics of patients with brain arteriovenous malformations (AVMs).
Methods—Prospectively collected data of 1289 consecutive AVM patients from 3 independent databases (1 multicenter [Berlin/Paris/Middle and Far East, n=662] and 2 single centers [New York, n=337, and Toronto, n=290]) were analyzed. The variables assessed were age at diagnosis, sex, AVM size, AVM drainage pattern, AVM location in functionally important brain areas ("eloquence"), and type of presentation (hemorrhage, seizure, chronic headache, or focal neurologic deficit). Comparisons were made by ANOVA, contingency tables, and log-linear models.
Results—Overall, mean age at diagnosis was 31.2 years (95% CI 30.2 to 32.2 years), and 45% of the patients were female (95% CI 42% to 47%). AVM maximum diameter was <3 cm in 38% (95% CI 35% to 41%). Deep venous drainage was present in 55% (95% CI 52% to 59%). An eloquent AVM location was described in 71% (95% CI 69% to 74%). AVM hemorrhage occurred in 53% (95% CI 51% to 56%). Generalized or focal seizures were described in 30% (95% CI 27% to 33%) and 10% (95% CI 8% to 12%), respectively. Chronic headache was recorded in 14% (95% CI 12% to 16%). Persistent neurological deficits were found in 7% (95% CI 6% to 9%), and progressive neurological deficits in 5% (95% CI 4% to 6%). Significant differences between centers were found for age (P<0.001), sex (P=0.04), eloquence (P=0.04), size (P<0.001), hemorrhage (P=0.006), persistent neurological deficit (P<0.001), and reversible neurological deficit (P=0.013). The intercenter difference found for hemorrhage frequency did not remain after adjustment for AVM size.
Conclusions—Baseline characteristics differed considerably between centers. The differences found in patient age and AVM size may be explained by center-specific referral patterns and the influence of access to treatment resources, whereas those found for other characteristics may be attributable to center-specific definitions. Analysis of natural history data from tertiary referral center databases may be improved by consistent definitions applicable to the entire population of AVM patients.
Key Words: cerebral arteriovenous malformations • cerebral hemorrhage • cerebrovascular disorders • epidemiology • intracerebral hemorrhage
This article has been cited by other articles:
 |
|
 |
|
  M V Jayaraman, R A McTaggart, G M Sachs, and C E Doberstein Cerebellar pial arteriovenous malformations presenting with medullary venous hypertension: imaging and endovascular treatment JNIS, September 15, 2009; (2009) jnis.2009.000471v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. van Beijnum, J. J. Bhattacharya, C. E. Counsell, V. Papanastassiou, V. Ritchie, R. C. Roberts, R. J. Sellar, C. Warlow, R. A.-S. Salman, and on behalf of the SIVMS Collaborators Patterns of Brain Arteriovenous Malformation Treatment: Prospective, Population-Based Study Stroke, December 1, 2008; 39(12): 3216 - 3221. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. L. Lasjaunias, P. Landrieu, G. Rodesch, H. Alvarez, A. Ozanne, S. Holmin, W.-Y. Zhao, S. Geibprasert, D. Ducreux, and T. Krings Cerebral Proliferative Angiopathy: Clinical and Angiographic Description of an Entity Different From Cerebral AVMs Stroke, March 1, 2008; 39(3): 878 - 885. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. V. Khaw When Race/Ethnicity Matters More Than Size Stroke, September 1, 2007; 38(9): 2405 - 2406. [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]
|
|
|
|
 |
|
 M. Cronqvist, R. Wirestam, B. Ramgren, L. Brandt, B. Romner, O. Nilsson, H. Saveland, S. Holtas, and E.-M. Larsson Endovascular Treatment of Intracerebral Arteriovenous Malformations: Procedural Safety, Complications, and Results Evaluated by MR Imaging, Including Diffusion and Perfusion Imaging AJNR Am. J. Neuroradiol., January 1, 2006; 27(1): 162 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Schauble, G.D. Cascino, B.E. Pollock, D.A. Gorman, S. Weigand, A.A. Cohen-Gadol, and R.L. McClelland Seizure outcomes after stereotactic radiosurgery for cerebral arteriovenous malformations Neurology, August 24, 2004; 63(4): 683 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.V. Khaw, J.P. Mohr, R.R. Sciacca, H.C. Schumacher, A. Hartmann, J. Pile-Spellman, H. Mast, and C. Stapf Association of Infratentorial Brain Arteriovenous Malformations With Hemorrhage at Initial Presentation Stroke, March 1, 2004; 35(3): 660 - 663. [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 Prospective, Population-Based Detection of Intracranial Vascular Malformations in Adults: The Scottish Intracranial Vascular Malformation Study (SIVMS) Stroke, May 1, 2003; 34(5): 1163 - 1169. [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]
|
|
|
|
 |
|
 C Stapf, J P Mohr, J Pile-Spellman, R R Sciacca, A Hartmann, H C Schumacher, and H Mast Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation J. Neurol. Neurosurg. Psychiatry, September 1, 2002; 73(3): 294 - 298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Gounis, B. B. Lieber, A. K. Wakhloo, R. Siekmann, and L.N. Hopkins Effect of Glacial Acetic Acid and Ethiodized Oil Concentration on Embolization with N-Butyl 2-Cyanoacrylate: An in Vivo Investigation AJNR Am. J. Neuroradiol., June 1, 2002; 23(6): 938 - 944. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Mansmann, P. Lasjaunias, H. J. Meisel, M. Piotin, and J. Moret Treatment of Patients with Cerebral Arteriovenous Malformations * Drs Piotin and Moret respond: Radiology, June 1, 2002; 223(3): 879 - 881. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Al-Shahi and C. Warlow A systematic review of the frequency and prognosis of arteriovenous malformations of the brain in adults Brain, October 1, 2001; 124(10): 1900 - 1926. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stapf, J. P. Mohr, R. R. Sciacca, A. Hartmann, B. D. Aagaard, J. Pile-Spellman, and H. Mast Incident Hemorrhage Risk of Brain Arteriovenous Malformations Located in the Arterial Borderzones Stroke, October 1, 2000; 31(10): 2365 - 2368. [Abstract] [Full Text] [PDF]
|
|