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UNSPECIFIED (2006) Clinical outcome after first and recurrent hemorrhage in patients with untreated brain arteriovenous malformation. Stroke, 37 . pp. 1243-1247.

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Abstract

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

Item Type:	Article
RIS ID:	https://nottingham-repository.worktribe.com/output/1018599
Keywords:	cerebral arteriovenous malformations intracerebral hemorrhage intracranial hemorrhage outcome subarachnoid hemorrhage
Schools/Departments:	University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine > Division of Clinical Neuroscience
Related URLs:	URL URL Type http://stroke.ahajournals.org/ Publisher
Depositing User:	Sayers, Hazel
Date Deposited:	15 May 2007
Last Modified:	04 May 2020 20:29
URI:	https://eprints.nottingham.ac.uk/id/eprint/502

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