TY - CHAP
T1 - The natural history of cerebral arteriovenous malformations
AU - Can, Anil
AU - Gross, Bradley A.
AU - Du, Rose
N1 - Publisher Copyright: © 2017 Elsevier B.V.
PY - 2017
Y1 - 2017
N2 - Cerebral arteriovenous malformations (AVMs) are composed of a complex tangle of abnormal arteries and veins and are a significant source of cerebral hemorrhage and consequent morbidity and mortality in young adults, representing a diagnostic and therapeutic challenge. Current natural-history studies of cerebral AVMs report overall annual rates of 1% and 3% for the risk of epilepsy and hemorrhage, respectively. Unruptured AVMs have an annual hemorrhage rate of 2.2% while ruptured lesions have an annual hemorrhage rate of 4.5%. These hemorrhage rates are can change over time, particularly for hemorrhagic lesions, with the rebleed rate ranging from 6% to 15.8% in the first year after rupture across several studies. Besides hemorrhage, other significant risk factors for AVM hemorrhage include deep location, deep venous drainage, associated aneurysms, and pregnancy. Other factors include patient age, sex, and small AVM size, which are not currently considered significant risk factors for AVM hemorrhage. In addition to hemorrhage risk and seizure risk, the natural history of an AVM also encompasses the daily psychologic burden that a patient must endure knowing that he or she possesses an untreated AVM. This chapter reviews the epidemiology, clinical features, and natural history of cerebral AVMs.
AB - Cerebral arteriovenous malformations (AVMs) are composed of a complex tangle of abnormal arteries and veins and are a significant source of cerebral hemorrhage and consequent morbidity and mortality in young adults, representing a diagnostic and therapeutic challenge. Current natural-history studies of cerebral AVMs report overall annual rates of 1% and 3% for the risk of epilepsy and hemorrhage, respectively. Unruptured AVMs have an annual hemorrhage rate of 2.2% while ruptured lesions have an annual hemorrhage rate of 4.5%. These hemorrhage rates are can change over time, particularly for hemorrhagic lesions, with the rebleed rate ranging from 6% to 15.8% in the first year after rupture across several studies. Besides hemorrhage, other significant risk factors for AVM hemorrhage include deep location, deep venous drainage, associated aneurysms, and pregnancy. Other factors include patient age, sex, and small AVM size, which are not currently considered significant risk factors for AVM hemorrhage. In addition to hemorrhage risk and seizure risk, the natural history of an AVM also encompasses the daily psychologic burden that a patient must endure knowing that he or she possesses an untreated AVM. This chapter reviews the epidemiology, clinical features, and natural history of cerebral AVMs.
KW - arteriovenous malformation
KW - intracerebral hemorrhage
KW - intraventricular hemorrhage
KW - natural history
KW - nidus
KW - rebleeding
KW - risk factor
KW - stroke
KW - subarachnoid hemorrhage
KW - vascular malformation
UR - http://www.scopus.com/inward/record.url?scp=85020092979&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/B978-0-444-63640-9.00002-3
DO - https://doi.org/10.1016/B978-0-444-63640-9.00002-3
M3 - Chapter
C2 - 28552137
T3 - Handbook of Clinical Neurology
SP - 15
EP - 24
BT - Handbook of Clinical Neurology
PB - Elsevier B.V
ER -