TY - JOUR
T1 - The presentation and clinical course of intracranial developmental venous anomalies in adults
T2 - a systematic review and prospective, population-based study
AU - SIVMS Collaborators
AU - Hon, Jennifer M. L.
AU - Bhattacharya, Jo J.
AU - Counsell, Carl E.
AU - Papanastassiou, Vakis
AU - Ritchie, Vaughn
AU - Roberts, Richard C.
AU - Sellar, Robin J.
AU - Warlow, Charles P.
AU - Salman, Rustam Al-Shahi
PY - 2009/6
Y1 - 2009/6
N2 - Background and Purpose-Reported risks of hemorrhage from intracranial developmental venous anomalies (DVAs) vary, so we investigated this in a systematic review and population-based study.Methods-We systematically reviewed the literature (Ovid Medline and Embase to November 7, 2007) and selected studies of >= 20 participants with >= 1 DVA(s) that described their clinical presentation and/or their clinical course over a specified follow-up period. We also identified every adult first diagnosed with a DVA in Scotland from 1999 to 2003 and followed them in a prospective, population-based study.Results-Of 2068 articles detected by the literature search, 15 met our inclusion criteria and described clinical presentation, 8 of which also described the clinical course of DVAs. In the 15 studies of 714 people first presenting with a DVA, 61% were incidental findings, the mode of presentation was unclear in 23%, 6% presented with nonhemorrhagic focal neurological deficit, 6% had caused symptomatic hemorrhage, 4% were associated with epileptic seizure, and <1% were associated with infarction. In studies of the clinical course of 422 people with a DVA, the hemorrhage rate after first presentation ranged from 0% to 1.28% per year. In the population-based study of 93 adults with DVAs, 98% were incidental, 1% presented with symptomatic hemorrhage, and 1% presented with an infarct, but there were no symptomatic hemorrhages or infarcts in 492 person-years of follow-up (0% per person-year; 95% CI, 0% to 0.7%).Conclusions-Intracranial DVAs have a benign presentation and clinical course. (Stroke. 2009; 40: 1980-1985.)
AB - Background and Purpose-Reported risks of hemorrhage from intracranial developmental venous anomalies (DVAs) vary, so we investigated this in a systematic review and population-based study.Methods-We systematically reviewed the literature (Ovid Medline and Embase to November 7, 2007) and selected studies of >= 20 participants with >= 1 DVA(s) that described their clinical presentation and/or their clinical course over a specified follow-up period. We also identified every adult first diagnosed with a DVA in Scotland from 1999 to 2003 and followed them in a prospective, population-based study.Results-Of 2068 articles detected by the literature search, 15 met our inclusion criteria and described clinical presentation, 8 of which also described the clinical course of DVAs. In the 15 studies of 714 people first presenting with a DVA, 61% were incidental findings, the mode of presentation was unclear in 23%, 6% presented with nonhemorrhagic focal neurological deficit, 6% had caused symptomatic hemorrhage, 4% were associated with epileptic seizure, and <1% were associated with infarction. In studies of the clinical course of 422 people with a DVA, the hemorrhage rate after first presentation ranged from 0% to 1.28% per year. In the population-based study of 93 adults with DVAs, 98% were incidental, 1% presented with symptomatic hemorrhage, and 1% presented with an infarct, but there were no symptomatic hemorrhages or infarcts in 492 person-years of follow-up (0% per person-year; 95% CI, 0% to 0.7%).Conclusions-Intracranial DVAs have a benign presentation and clinical course. (Stroke. 2009; 40: 1980-1985.)
KW - hemorrhagic
KW - intracranial developmental venous anomaly
KW - stroke
KW - vascular malformations
U2 - 10.1161/STROKEAHA.108.533034
DO - 10.1161/STROKEAHA.108.533034
M3 - Article
C2 - 19390075
SN - 0039-2499
VL - 40
SP - 1980
EP - 1985
JO - Stroke
JF - Stroke
IS - 6
ER -