The presentation and clinical course of intracranial developmental venous anomalies in adults

Jennifer M L Hon, Jo J Bhattacharya, Carl E Counsell, Vakis Papanastassiou, Vaughn Ritchie, Richard C Roberts, Robin J Sellar, Charles P Warlow, Rustam Al-Shahi Salman, SIVMS Collaborators

Research output: Contribution to journalArticle

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Abstract

Background and Purpose— Reported risks of hemorrhage from intracranial developmental venous anomalies (DVAs) vary, so we investigated this in a systematic review and population-based study.

Methods— We systematically reviewed the literature (Ovid Medline and Embase to November 7, 2007) and selected studies of ≥20 participants with ≥1 DVA(s) that described their clinical presentation and/or their clinical course over a specified follow-up period. We also identified every adult first diagnosed with a DVA in Scotland from 1999 to 2003 and followed them in a prospective, population-based study.

Results— Of 2068 articles detected by the literature search, 15 met our inclusion criteria and described clinical presentation, 8 of which also described the clinical course of DVAs. In the 15 studies of 714 people first presenting with a DVA, 61% were incidental findings, the mode of presentation was unclear in 23%, 6% presented with nonhemorrhagic focal neurological deficit, 6% had caused symptomatic hemorrhage, 4% were associated with epileptic seizure, and <1% were associated with infarction. In studies of the clinical course of 422 people with a DVA, the hemorrhage rate after first presentation ranged from 0% to 1.28% per year. In the population-based study of 93 adults with DVAs, 98% were incidental, 1% presented with symptomatic hemorrhage, and 1% presented with an infarct, but there were no symptomatic hemorrhages or infarcts in 492 person-years of follow-up (0% per person-year; 95% CI, 0% to 0.7%).

Conclusions— Intracranial DVAs have a benign presentation and clinical course.
Original languageEnglish
Pages (from-to)1980-1985
Number of pages6
JournalStroke
Volume40
Issue number6
Early online date23 Apr 2009
DOIs
Publication statusPublished - Jun 2009

Fingerprint

Hemorrhage
Population
Incidental Findings
Intracranial Hemorrhages
Scotland
Infarction
Epilepsy
Clinical Studies

Keywords

  • adult
  • aged
  • aged, 80 and over
  • cerebral Hemorrhage
  • cerebral infarction
  • cognition disorders
  • female
  • follow-up studies
  • humans
  • intracranial arteriovenous malformations
  • magnetic resonance imaging
  • male
  • middle aged
  • population
  • prospective studies
  • Scotland
  • seizures
  • treatment outcome
  • young adult

Cite this

Hon, J. M. L., Bhattacharya, J. J., Counsell, C. E., Papanastassiou, V., Ritchie, V., Roberts, R. C., ... SIVMS Collaborators (2009). The presentation and clinical course of intracranial developmental venous anomalies in adults. Stroke, 40(6), 1980-1985. https://doi.org/10.1161/STROKEAHA.108.533034

The presentation and clinical course of intracranial developmental venous anomalies in adults. / Hon, Jennifer M L; Bhattacharya, Jo J; Counsell, Carl E; Papanastassiou, Vakis; Ritchie, Vaughn; Roberts, Richard C; Sellar, Robin J; Warlow, Charles P; Al-Shahi Salman, Rustam; SIVMS Collaborators.

In: Stroke, Vol. 40, No. 6, 06.2009, p. 1980-1985.

Research output: Contribution to journalArticle

Hon, JML, Bhattacharya, JJ, Counsell, CE, Papanastassiou, V, Ritchie, V, Roberts, RC, Sellar, RJ, Warlow, CP, Al-Shahi Salman, R & SIVMS Collaborators 2009, 'The presentation and clinical course of intracranial developmental venous anomalies in adults', Stroke, vol. 40, no. 6, pp. 1980-1985. https://doi.org/10.1161/STROKEAHA.108.533034
Hon, Jennifer M L ; Bhattacharya, Jo J ; Counsell, Carl E ; Papanastassiou, Vakis ; Ritchie, Vaughn ; Roberts, Richard C ; Sellar, Robin J ; Warlow, Charles P ; Al-Shahi Salman, Rustam ; SIVMS Collaborators. / The presentation and clinical course of intracranial developmental venous anomalies in adults. In: Stroke. 2009 ; Vol. 40, No. 6. pp. 1980-1985.
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abstract = "Background and Purpose— Reported risks of hemorrhage from intracranial developmental venous anomalies (DVAs) vary, so we investigated this in a systematic review and population-based study.Methods— We systematically reviewed the literature (Ovid Medline and Embase to November 7, 2007) and selected studies of ≥20 participants with ≥1 DVA(s) that described their clinical presentation and/or their clinical course over a specified follow-up period. We also identified every adult first diagnosed with a DVA in Scotland from 1999 to 2003 and followed them in a prospective, population-based study.Results— Of 2068 articles detected by the literature search, 15 met our inclusion criteria and described clinical presentation, 8 of which also described the clinical course of DVAs. In the 15 studies of 714 people first presenting with a DVA, 61{\%} were incidental findings, the mode of presentation was unclear in 23{\%}, 6{\%} presented with nonhemorrhagic focal neurological deficit, 6{\%} had caused symptomatic hemorrhage, 4{\%} were associated with epileptic seizure, and <1{\%} were associated with infarction. In studies of the clinical course of 422 people with a DVA, the hemorrhage rate after first presentation ranged from 0{\%} to 1.28{\%} per year. In the population-based study of 93 adults with DVAs, 98{\%} were incidental, 1{\%} presented with symptomatic hemorrhage, and 1{\%} presented with an infarct, but there were no symptomatic hemorrhages or infarcts in 492 person-years of follow-up (0{\%} per person-year; 95{\%} CI, 0{\%} to 0.7{\%}).Conclusions— Intracranial DVAs have a benign presentation and clinical course.",
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AU - Roberts, Richard C

AU - Sellar, Robin J

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AB - Background and Purpose— Reported risks of hemorrhage from intracranial developmental venous anomalies (DVAs) vary, so we investigated this in a systematic review and population-based study.Methods— We systematically reviewed the literature (Ovid Medline and Embase to November 7, 2007) and selected studies of ≥20 participants with ≥1 DVA(s) that described their clinical presentation and/or their clinical course over a specified follow-up period. We also identified every adult first diagnosed with a DVA in Scotland from 1999 to 2003 and followed them in a prospective, population-based study.Results— Of 2068 articles detected by the literature search, 15 met our inclusion criteria and described clinical presentation, 8 of which also described the clinical course of DVAs. In the 15 studies of 714 people first presenting with a DVA, 61% were incidental findings, the mode of presentation was unclear in 23%, 6% presented with nonhemorrhagic focal neurological deficit, 6% had caused symptomatic hemorrhage, 4% were associated with epileptic seizure, and <1% were associated with infarction. In studies of the clinical course of 422 people with a DVA, the hemorrhage rate after first presentation ranged from 0% to 1.28% per year. In the population-based study of 93 adults with DVAs, 98% were incidental, 1% presented with symptomatic hemorrhage, and 1% presented with an infarct, but there were no symptomatic hemorrhages or infarcts in 492 person-years of follow-up (0% per person-year; 95% CI, 0% to 0.7%).Conclusions— Intracranial DVAs have a benign presentation and clinical course.

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KW - cognition disorders

KW - female

KW - follow-up studies

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KW - magnetic resonance imaging

KW - male

KW - middle aged

KW - population

KW - prospective studies

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KW - seizures

KW - treatment outcome

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DO - 10.1161/STROKEAHA.108.533034

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VL - 40

SP - 1980

EP - 1985

JO - Stroke

JF - Stroke

SN - 0039-2499

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ER -