Hemorrhage rates from brain arteriovenous malformation in patients with hereditary hemorrhagic telangiectasia
| Autor: | Kim, Helen, Nelson, Jeffrey, Krings, Timo, terBrugge, Karel G, McCulloch, Charles E, Lawton, Michael T, Young, William L, Faughnan, Marie E, Brain Vascular Malformation Consortium HHT Investigator Group |
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| Rok vydání: | 2015 |
| Předmět: |
Intracranial Arteriovenous Malformations
Adult Male Adolescent Clinical Sciences Cardiorespiratory Medicine and Haematology hereditary hemorrhagic Cohort Studies Young Adult Rare Diseases Recurrence Humans telangiectasia Brain Vascular Malformation Consortium HHT Investigator Group Child Preschool arteriovenous malformations Retrospective Studies Aged Pediatric cerebral hemorrhage Neurology & Neurosurgery Prevention Neurosciences Infant Middle Aged Newborn Aneurysm Survival Analysis Ruptured Brain Disorders Stroke Socioeconomic Factors natural history Congenital Structural Anomalies Female Intracranial Hemorrhages |
| Zdroj: | Stroke, vol 46, iss 5 |
| Popis: | Background and purposeHereditary hemorrhagic telangiectasia (HHT) is a systemic disease characterized by mucocutaneous telangiectasias, epistaxis, and arteriovenous malformations (AVMs). Intracranial hemorrhage (ICH) rates in this population are not well described. We report ICH rates and characteristics in HHT patients with brain AVMs (HHT-BAVMs).MethodsWe studied the first 153 HHT-BAVM patients with follow-up data enrolled in the Brain Vascular Malformation Consortium HHT Project. We estimated ICH rates after BAVM diagnosis.ResultsThe majority of patients were women (58%) and white (98%). The mean age at BAVM diagnosis was 31±19 years (range, 0-70), with 61% of cases diagnosed on asymptomatic screening. Overall, 14% presented with ICH; among symptomatic cases, 37% presented ruptured. During 493 patient-years of follow-up, 5 ICH events occurred yielding a rate of 1.02% per year (95% confidence interval, 0.42-2.44%). ICH-free survival differed significantly by ICH presentation (P=0.003); ruptured cases had a higher ICH rate (10.07%; 95% confidence interval, 3.25-31.21%) than unruptured cases (0.43%; 95% confidence interval, 0.11-1.73%).ConclusionsPatients with HHT-BAVM who present with hemorrhage are at a higher risk for rehemorrhage compared with patients with BAVM detected presymptomatically. |
| Databáze: | OpenAIRE |
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