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(Stroke. 2003;34:1163.)
© 2003 American Heart Association, Inc.

Original Contributions

Prospective, Population-Based Detection of Intracranial Vascular Malformations in Adults

The Scottish Intracranial Vascular Malformation Study (SIVMS)

Rustam Al-Shahi, MA, MRCP(UK); Jo J. Bhattacharya, FRCR; David G. Currie, FRCS; Vakis Papanastassiou, FRCS; Vaughn Ritchie, MB, ChB; Richard C. Roberts, FRCP; Robin J. Sellar, FRCR Charles P. Warlow, FRCP for the SIVMS Collaborators

From the Department of Clinical Neurosciences, Western General Hospital, Edinburgh (R.A-S., R.J.S., C.P.W.); Institute of Neurological Sciences, Southern General Hospital, Glasgow (J.J.B., V.P.); Department of Neurosurgery, Aberdeen Royal Infirmary, Aberdeen (D.G.C.); Fauldhouse Health Centre, Fauldhouse (V.R.); and Department of Neurology, Ninewells Hospital and Medical School, Dundee (R.C.R.), Scotland.

Correspondence to Rustam Al-Shahi, MA, MRCP(UK), Department of Clinical Neurosciences, Western General Hospital, Edinburgh EH4 2XU, Scotland. E-mail Rustam.Al-Shahi{at}ed.ac.uk

Background and Purpose— Intracranial vascular malformations (IVMs) are an important cause of intracranial hemorrhage, epilepsy, and long-term disability in adults. There are no published prospective, population-based studies dedicated to the detection of any type of IVM (cavernous malformations, venous malformations, and arteriovenous malformations [AVMs] of the brain or dura). Therefore, we established the Scottish Intracranial Vascular Malformation Study (SIVMS) to monitor detection and long-term prognosis of people with IVMs.

Methods— We used multiple overlapping sources of case ascertainment to identify adults (aged 16 years) with a first-ever-in-a-lifetime diagnosis of any type of IVM made between January 1, 1999, and December 31, 2000, while resident in Scotland (mid-1999 adult population estimate 4 110 956).

Results— Of 418 notifications to SIVMS, 190 adults (45%) were included, 181 (95%) of whom were deemed to harbor a definite IVM after review of diagnostic brain imaging and/or reports of autopsy/surgical excision pathology. The crude detection rate (per 100 000 adults per year) was 2.27 (95% CI, 1.96 to 2.62) for all IVMs, 1.12 (95% CI, 0.90 to 1.37) for brain AVMs, 0.56 (95% CI, 0.41 to 0.75) for cavernous malformations, 0.43 (95% CI, 0.31 to 0.61) for venous malformations, and 0.16 (95% CI, 0.08 to 0.27) for dural AVMs.

Conclusions— In addition to providing data on the public health importance and comparative epidemiology of IVMs, continuing recruitment and follow-up of this prospective, population-based cohort will provide estimates of IVM prognosis.

Key Words: central nervous system • cerebral arteriovenous malformations • incidence • prognosis • registries • vascular malformations

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