title: Incidence of adult brain arteriovenous malformation hemorrhage in a prospective population-based stroke survey.
abstract: BACKGROUND
  Brain arteriovenous malformations (AVMs) represent a potential source of intracranial hemorrhage, especially in young adults, but prospective population-based incidence data on AVM hemorrhage are lacking. We investigated the incidence of first-ever AVM hemorrhage in adults based on population data from the Northern Manhattan Stroke Study (NOMASS).
  
  
  METHODS
  NOMASS is a prospective, population-based, stroke incidence survey collecting all hospitalized and nonhospitalized cases with first-ever (incident) stroke over the age of 20 in a ZIP code-defined area. All patients undergo CT and/or MR brain imaging and clinical data are systematically collected from the medical records. For this study, data on all cases with incident intracranial hemorrhage, i.e. any intracerebral, intraventricular and/or subarachnoid hemorrhage, occurring between July 1, 1993 and June 30, 1997 were used. Patients with intracranial hemorrhage due to trauma, tumor or intracranial vascular malformations other than a previously unknown AVM were excluded from the study.
  
  
  RESULTS
  Of the 207 patients diagnosed with a first-ever intracranial hemorrhage, 3 cases (1.4%) with an underlying brain AVM were identified. The crude incidence rate for first-ever AVM hemorrhage in our adult population was 0.55 per 100,000 person-years (95% confidence interval 0.11-1.61).
  
  
  CONCLUSIONS
  Our results support prior findings from retrospective surveys. Population-based studies providing a prospective design for AVM detection and diagnosis are needed to confirm the data.
authors.affiliation: Stroke Center/The Neurological Institute, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. christian.stapf@medizin.fu-berlin.de
authors.forename: Christian
authors.initials: C
authors.lastname: Stapf
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Labovitz
authors.forename: Robert R
authors.initials: RR
authors.lastname: Sciacca
authors.forename: Henning
authors.initials: H
authors.lastname: Mast
authors.forename: Jay P
authors.initials: JP
authors.lastname: Mohr
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D002538:Intracranial Arteriovenous Malformations / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011446:Prospective Studies; D020521:Stroke / Q000453:epidemiology*