Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages

prospective, population-based study

C Cordonnier, Rustam Al-Shahi Salman, J J Bhattacharya, Carl Edward Counsell, V Papanastassiou, V Ritchie, R C Roberts, R J Sellar, C Warlow, SIVMS Collaborators

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objective: To determine the imaging and demographic characteristics of intracranial haemorrhages, which are subsequently found to be due to an underlying intracranial vascular malformation (IVM).
Methods: We compared the demographic and brain imaging characteristics of adults presenting with intracranial haemorrhage, subsequently found to be due to a brain arteriovenous malformation (BAVM), dural arteriovenous fistula (DAVF) or cavernous malformation (CM) in a prospective, population-based cohort of adults diagnosed for the first time with an IVM (The Scottish IVM Study (SIVMS)).

Results: Of the 141 adults in SIVMS who presented with intracranial haemorrhage, those with CMs presented at a younger age and were less handicapped. A total of 115 (82%) had intracerebral haemorrhage (ICH) with or without subarachnoid, intraventricular or subdural extension. ICH without extension into other compartments accounted for all CM bleeds, but only 50% of BAVM and DAVF bleeds. Median haematoma volumes differed (Kruskal-Wallis, p<0.0001): ICH due to BAVM (16.0 cm(3), inter-quartile range (IQR) 4.7 to 42.0) and DAVF (14.1 cm(3), IQR 4.9 to 21.5) were similar, but CM haematoma volumes were smaller (median 1.8 cm(3), IQR 1.3 to 4.3). These findings were robust in sensitivity analyses. Small haematoma volumes occurred among all IVM types; the largest haematoma volume due to CM was 12 cm(3), and volumes of >34 cm(3) were only due to BAVM.

Conclusions: Intracranial haemorrhages found to be due to IVMs differ in adults' age of presentation and clinical severity, as well as the volume and distribution of the haematoma within the brain compartments.
Original languageEnglish
Pages (from-to)47-51
Number of pages5
JournalJournal of Neurology, Neurosurgery & Psychiatry
Volume79
Issue number1
DOIs
Publication statusPublished - Jan 2008

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Vascular Malformations
Intracranial Hemorrhages
Arteriovenous Malformations
Hemorrhage
Central Nervous System Vascular Malformations
Cerebral Hemorrhage
Brain
Hematoma
Population
Demography
Disabled Persons
Neuroimaging

Keywords

  • cerebral cavernous malformations
  • ABC/2 estimation technique
  • Natural-history
  • arteriovenous-malformations
  • intracerebral hemorrhage
  • brain-stem
  • prognosis
  • frequency
  • agreement

Cite this

Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages : prospective, population-based study. / Cordonnier, C; Al-Shahi Salman, Rustam; Bhattacharya, J J; Counsell, Carl Edward; Papanastassiou, V; Ritchie, V; Roberts, R C; Sellar, R J; Warlow, C; SIVMS Collaborators.

In: Journal of Neurology, Neurosurgery & Psychiatry, Vol. 79, No. 1, 01.2008, p. 47-51.

Research output: Contribution to journalArticle

Cordonnier, C, Al-Shahi Salman, R, Bhattacharya, JJ, Counsell, CE, Papanastassiou, V, Ritchie, V, Roberts, RC, Sellar, RJ, Warlow, C & SIVMS Collaborators 2008, 'Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages: prospective, population-based study', Journal of Neurology, Neurosurgery & Psychiatry, vol. 79, no. 1, pp. 47-51. https://doi.org/10.1136/jnnp.2006.113753
Cordonnier, C ; Al-Shahi Salman, Rustam ; Bhattacharya, J J ; Counsell, Carl Edward ; Papanastassiou, V ; Ritchie, V ; Roberts, R C ; Sellar, R J ; Warlow, C ; SIVMS Collaborators. / Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages : prospective, population-based study. In: Journal of Neurology, Neurosurgery & Psychiatry. 2008 ; Vol. 79, No. 1. pp. 47-51.
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abstract = "Objective: To determine the imaging and demographic characteristics of intracranial haemorrhages, which are subsequently found to be due to an underlying intracranial vascular malformation (IVM). Methods: We compared the demographic and brain imaging characteristics of adults presenting with intracranial haemorrhage, subsequently found to be due to a brain arteriovenous malformation (BAVM), dural arteriovenous fistula (DAVF) or cavernous malformation (CM) in a prospective, population-based cohort of adults diagnosed for the first time with an IVM (The Scottish IVM Study (SIVMS)). Results: Of the 141 adults in SIVMS who presented with intracranial haemorrhage, those with CMs presented at a younger age and were less handicapped. A total of 115 (82{\%}) had intracerebral haemorrhage (ICH) with or without subarachnoid, intraventricular or subdural extension. ICH without extension into other compartments accounted for all CM bleeds, but only 50{\%} of BAVM and DAVF bleeds. Median haematoma volumes differed (Kruskal-Wallis, p<0.0001): ICH due to BAVM (16.0 cm(3), inter-quartile range (IQR) 4.7 to 42.0) and DAVF (14.1 cm(3), IQR 4.9 to 21.5) were similar, but CM haematoma volumes were smaller (median 1.8 cm(3), IQR 1.3 to 4.3). These findings were robust in sensitivity analyses. Small haematoma volumes occurred among all IVM types; the largest haematoma volume due to CM was 12 cm(3), and volumes of >34 cm(3) were only due to BAVM. Conclusions: Intracranial haemorrhages found to be due to IVMs differ in adults' age of presentation and clinical severity, as well as the volume and distribution of the haematoma within the brain compartments.",
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T1 - Differences between intracranial vascular malformation types in the characteristics of their presenting haemorrhages

T2 - prospective, population-based study

AU - Cordonnier, C

AU - Al-Shahi Salman, Rustam

AU - Bhattacharya, J J

AU - Counsell, Carl Edward

AU - Papanastassiou, V

AU - Ritchie, V

AU - Roberts, R C

AU - Sellar, R J

AU - Warlow, C

AU - SIVMS Collaborators

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N2 - Objective: To determine the imaging and demographic characteristics of intracranial haemorrhages, which are subsequently found to be due to an underlying intracranial vascular malformation (IVM). Methods: We compared the demographic and brain imaging characteristics of adults presenting with intracranial haemorrhage, subsequently found to be due to a brain arteriovenous malformation (BAVM), dural arteriovenous fistula (DAVF) or cavernous malformation (CM) in a prospective, population-based cohort of adults diagnosed for the first time with an IVM (The Scottish IVM Study (SIVMS)). Results: Of the 141 adults in SIVMS who presented with intracranial haemorrhage, those with CMs presented at a younger age and were less handicapped. A total of 115 (82%) had intracerebral haemorrhage (ICH) with or without subarachnoid, intraventricular or subdural extension. ICH without extension into other compartments accounted for all CM bleeds, but only 50% of BAVM and DAVF bleeds. Median haematoma volumes differed (Kruskal-Wallis, p<0.0001): ICH due to BAVM (16.0 cm(3), inter-quartile range (IQR) 4.7 to 42.0) and DAVF (14.1 cm(3), IQR 4.9 to 21.5) were similar, but CM haematoma volumes were smaller (median 1.8 cm(3), IQR 1.3 to 4.3). These findings were robust in sensitivity analyses. Small haematoma volumes occurred among all IVM types; the largest haematoma volume due to CM was 12 cm(3), and volumes of >34 cm(3) were only due to BAVM. Conclusions: Intracranial haemorrhages found to be due to IVMs differ in adults' age of presentation and clinical severity, as well as the volume and distribution of the haematoma within the brain compartments.

AB - Objective: To determine the imaging and demographic characteristics of intracranial haemorrhages, which are subsequently found to be due to an underlying intracranial vascular malformation (IVM). Methods: We compared the demographic and brain imaging characteristics of adults presenting with intracranial haemorrhage, subsequently found to be due to a brain arteriovenous malformation (BAVM), dural arteriovenous fistula (DAVF) or cavernous malformation (CM) in a prospective, population-based cohort of adults diagnosed for the first time with an IVM (The Scottish IVM Study (SIVMS)). Results: Of the 141 adults in SIVMS who presented with intracranial haemorrhage, those with CMs presented at a younger age and were less handicapped. A total of 115 (82%) had intracerebral haemorrhage (ICH) with or without subarachnoid, intraventricular or subdural extension. ICH without extension into other compartments accounted for all CM bleeds, but only 50% of BAVM and DAVF bleeds. Median haematoma volumes differed (Kruskal-Wallis, p<0.0001): ICH due to BAVM (16.0 cm(3), inter-quartile range (IQR) 4.7 to 42.0) and DAVF (14.1 cm(3), IQR 4.9 to 21.5) were similar, but CM haematoma volumes were smaller (median 1.8 cm(3), IQR 1.3 to 4.3). These findings were robust in sensitivity analyses. Small haematoma volumes occurred among all IVM types; the largest haematoma volume due to CM was 12 cm(3), and volumes of >34 cm(3) were only due to BAVM. Conclusions: Intracranial haemorrhages found to be due to IVMs differ in adults' age of presentation and clinical severity, as well as the volume and distribution of the haematoma within the brain compartments.

KW - cerebral cavernous malformations

KW - ABC/2 estimation technique

KW - Natural-history

KW - arteriovenous-malformations

KW - intracerebral hemorrhage

KW - brain-stem

KW - prognosis

KW - frequency

KW - agreement

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DO - 10.1136/jnnp.2006.113753

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JO - Journal of Neurology, Neurosurgery & Psychiatry

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