Natural course of unoperated intracranial arteriovenous malformations: study of 50 cases.
The clinical course of 50 patients with conservatively treated intracranial arteriovenous malformations (AVM's) was followed, most of them for more than 5 years. The average follow-up period was 13.4 years. The initial symptom was intracranial bleeding in 29 patients (58%) and seizure in 15 patients (30%). Small and deep-seated AVM's were associated with a high incidence of bleeding; however, repeated hemorrhages were not necessarily indicative of a poor prognosis. Children younger than 15 years had a better prognosis than adults. There was no correlation between pregnancy and bleeding. In the hemorrhage group, the incidence of rebleeding was 6.9% in the 1st year after initial rupture, 1.91% per year after 5 years, and 0.92% per year after 15 years. The overall incidence of rebleeding was 34.5% in the hemorrhage group. Of the 50 patients, 37 (74%) had a good clinical outcome, four (8%) had a fair outcome, and four (8%) had a poor outcome; five patients died.
Itoyama
Y
Y
Department of Neurosurgery, Kumamoto University Medical School, Japan.
Uemura
S
S
Ushio
Y
Y
Kuratsu
J
J
Nonaka
N
N
Wada
H
H
Sano
Y
Y
Fukumura
A
A
Yoshida
K
K
Yano
T
T
D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012640:Seizures / Q000209:etiology