Prospective, population-based detection of intracranial vascular malformations in adults - The Scottish Intracranial Vascular Malformation Study (SIVMS)

Rustam Al-Shahi, Jo J. Bhattacharya, David G. Currie, Vakis Papanastassiou, Vaughn Ritchie, Richard Roberts, Robin J. Sellar, Charles P. Warlow

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    269 Citations (Scopus)

    Abstract

    Background and Purpose— Intracranial vascular malformations (IVMs) are an important cause of intracranial hemorrhage, epilepsy, and long-term disability in adults. There are no published prospective, population-based studies dedicated to the detection of any type of IVM (cavernous malformations, venous malformations, and arteriovenous malformations [AVMs] of the brain or dura). Therefore, we established the Scottish Intracranial Vascular Malformation Study (SIVMS) to monitor detection and long-term prognosis of people with IVMs. Methods— We used multiple overlapping sources of case ascertainment to identify adults (aged 16 years) with a first-ever-in-a-lifetime diagnosis of any type of IVM made between January 1, 1999, and December 31, 2000, while resident in Scotland (mid-1999 adult population estimate 4 110 956). Results— Of 418 notifications to SIVMS, 190 adults (45%) were included, 181 (95%) of whom were deemed to harbor a definite IVM after review of diagnostic brain imaging and/or reports of autopsy/surgical excision pathology. The crude detection rate (per 100 000 adults per year) was 2.27 (95% CI, 1.96 to 2.62) for all IVMs, 1.12 (95% CI, 0.90 to 1.37) for brain AVMs, 0.56 (95% CI, 0.41 to 0.75) for cavernous malformations, 0.43 (95% CI, 0.31 to 0.61) for venous malformations, and 0.16 (95% CI, 0.08 to 0.27) for dural AVMs. Conclusions— In addition to providing data on the public health importance and comparative epidemiology of IVMs, continuing recruitment and follow-up of this prospective, population-based cohort will provide estimates of IVM prognosis.
    Original languageEnglish
    Pages (from-to)1163-1169
    Number of pages7
    JournalStroke
    Volume34
    Issue number5
    DOIs
    Publication statusPublished - May 2003

    Keywords

    • Central nervous system
    • Cerebral arteriovenous malformations
    • Incidence
    • Prognosis
    • Registries
    • Vascular malformations

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