Untreated clinical course of cerebral cavernous malformations: a prospective, population-based cohort study
| Autor: | Rustam, Al-Shahi Salman, Julie M, Hall, Margaret A, Horne, Fiona, Moultrie, Colin B, Josephson, Jo J, Bhattacharya, Carl E, Counsell, Gordon D, Murray, Vakis, Papanastassiou, Vaughn, Ritchie, Richard C, Roberts, Robin J, Sellar, Charles P, Warlow, F, Smith |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Risk Male Pediatrics medicine.medical_specialty Population Clinical Neurology MEDLINE Cerebral cavernous malformations 030218 nuclear medicine & medical imaging 03 medical and health sciences Sex Factors 0302 clinical medicine Neuroimaging Recurrence Humans Medicine Prospective Studies Medical diagnosis Prospective cohort study education Central Nervous System Vascular Malformations education.field_of_study business.industry Clinical course Articles Middle Aged 3. Good health Scotland Female Neurology (clinical) Epileptic seizure medicine.symptom business Intracranial Hemorrhages 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Al-Shahi Salman, R, Hall, J M, Horne, M A, Moultrie, F, Josephson, C B, Bhattacharya, J J, Counsell, C E, Murray, G D, Papanastassiou, V, Ritchie, V, Roberts, R C, Sellar, R J, Warlow, C P 2012, ' Untreated clinical course of cerebral cavernous malformations : a prospective, population-based cohort study ', Lancet Neurology, vol. 11, no. 3, pp. 217-224 . https://doi.org/10.1016/S1474-4422(12)70004-2 Lancet Neurology |
| ISSN: | 1474-4422 |
| DOI: | 10.1016/s1474-4422(12)70004-2 |
| Popis: | Summary Background Cerebral cavernous malformations (CCMs) are prone to bleeding but the risk of intracranial haemorrhage and focal neurological deficits, and the factors that might predict their occurrence, are unclear. We aimed to quantify these risks and investigate whether they are affected by sex and CCM location. Methods We undertook a population-based study using multiple overlapping sources of case ascertainment (including a Scotland-wide collaboration of neurologists, neurosurgeons, stroke physicians, radiologists, and pathologists, as well as searches of registers of hospital discharges and death certificates) to identify definite CCM diagnoses first made in Scottish residents between 1999 and 2003, which study neuroradiologists independently validated. We used multiple sources of prospective follow-up both to identify outcome events (which were assessed by use of brain imaging, by investigators masked to potential predictive factors) and to assess adults' dependence. The primary outcome was a composite of intracranial haemorrhage or focal neurological deficits (not including epileptic seizure) that were definitely or possibly related to CCM. Findings 139 adults had at least one definite CCM and 134 were alive at initial presentation. During 1177 person-years of follow-up (completeness 97%), for intracranial haemorrhage alone the 5-year risk of a first haemorrhage was lower than the risk of recurrent haemorrhage (2·4%, 95% CI 0·0–5·7 vs 29·5%, 4·1–55·0; p |
| Databáze: | OpenAIRE |
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