Complications of arteriovenous malformations rupture and medical management of hemorrhage

Giuseppe Lanzino, Ross Puffer

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Arteriovenous malformations (AVMs) are responsible for only 1-2% of all strokes and 4% of primary intracerebral hemorrhages. However, patients with intracranial hemorrhage from an AVM are usually younger than most stroke victims and AVMs are responsible for one-third of intracranial hemorrhages in young adults [1]. The incidence of hemorrhage as a presenting symptom of an intracranial AVM varies among different series in relation to the time period considered (before or after the widespread availability of non-invasive imaging studies) and the type of setting: Population-based study versus series of patients referred for tertiary specialized care. In a small retrospective but population-based study conducted between 1965 and 1992 in Olmsted County, 65% of patients with AVMs presented with hemorrhage [2]. With advances in imaging techniques and widespread availability of non-invasive imaging studies, the relative percentage of patients with AVMs presenting with hemorrhage is decreasing. In a prospective population-based study conducted in Scotland, 114 of 229 adults (50%) diagnosed with an intracranial parenchymal AVM between 1999 and 2003 suffered an intracranial hemorrhage as a presenting symptom [3]. Parenchymal hemorrhage is the most common mode of hemorrhagic presentation. In the Scottish Intracranial Vascular Malformations Study [4], 50% of the hemorrhages were strictly limited to the brain parenchyma and intraventricular hemorrhage (IVH) was present in 34%. Similarly in the study conducted in Olmsted County, intracerebral hemorrhage (ICH) was present in 41% of patients, subarachnoid hemorrhage (SAH) in 24%, IVH in 12%, and a combination of the different types in 23% [2]. In the Scottish study, location of the hematoma was lobar in 73%, deep in 11%, and infratentorial in 16% [1]. The median volume in 90 patients with ICH was 16 cm3 [5], and IVH was present in 34%.

Original languageEnglish (US)
Title of host publicationComprehensive Management of Arteriovenous Malformations of the Brain and Spine
PublisherCambridge University Press
Pages201-207
Number of pages7
ISBN (Electronic)9781139523943
ISBN (Print)9781107033887
DOIs
StatePublished - Jan 1 2015

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Arteriovenous Malformations
Rupture
Hemorrhage
Intracranial Arteriovenous Malformations
Intracranial Hemorrhages
Cerebral Hemorrhage
Stroke
Population
Vascular Malformations
Scotland
Subarachnoid Hemorrhage
Tertiary Healthcare
Hematoma
Young Adult
Incidence
Brain

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lanzino, G., & Puffer, R. (2015). Complications of arteriovenous malformations rupture and medical management of hemorrhage. In Comprehensive Management of Arteriovenous Malformations of the Brain and Spine (pp. 201-207). Cambridge University Press. https://doi.org/10.1017/CBO9781139523943.018

Complications of arteriovenous malformations rupture and medical management of hemorrhage. / Lanzino, Giuseppe; Puffer, Ross.

Comprehensive Management of Arteriovenous Malformations of the Brain and Spine. Cambridge University Press, 2015. p. 201-207.

Research output: Chapter in Book/Report/Conference proceedingChapter

Lanzino, G & Puffer, R 2015, Complications of arteriovenous malformations rupture and medical management of hemorrhage. in Comprehensive Management of Arteriovenous Malformations of the Brain and Spine. Cambridge University Press, pp. 201-207. https://doi.org/10.1017/CBO9781139523943.018
Lanzino G, Puffer R. Complications of arteriovenous malformations rupture and medical management of hemorrhage. In Comprehensive Management of Arteriovenous Malformations of the Brain and Spine. Cambridge University Press. 2015. p. 201-207 https://doi.org/10.1017/CBO9781139523943.018
Lanzino, Giuseppe ; Puffer, Ross. / Complications of arteriovenous malformations rupture and medical management of hemorrhage. Comprehensive Management of Arteriovenous Malformations of the Brain and Spine. Cambridge University Press, 2015. pp. 201-207
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