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Hemorrhage Rates and Risk Factors in the Natural History Course of Brain Arteriovenous Malformations

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Abstract

Brain arteriovenous malformations (AVMs) are abnormal connections of arteries and veins, resulting in arteriovenous shunting of blood. Primary medical therapy is lacking; treatment options include surgery, radiosurgery, and embolization, often in combination. Judicious selection of AVM patients for treatment requires balancing risk of treatment complications against the risk of hemorrhage in the natural history course. This review focuses on the epidemiology, hemorrhage risk, and factors influencing risk of hemorrhage in the untreated natural course associated with sporadic brain AVM.

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Acknowledgments

We thank the National Institute of Neurological Disorders and Stroke (NINDS) for their continued support of AVM research (R01 NS034949 and P01 NS044155).

Compliance With Ethics Requirement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from AVM patients included in studies from UCSF and KPNC. All other cited clinical studies describe ethical standards in cited manuscripts.

Conflict of Interest

W. Caleb Rutledge, Nerissa U. Ko, Michael T. Lawton, and Helen Kim declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA

    W. Caleb Rutledge & Michael T. Lawton

  2. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA

    Nerissa U. Ko

  3. Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California, San Francisco, 1001 Potrero Avenue, Box 1363, San Francisco, CA, 94110, USA

    Helen Kim

Authors
  1. W. Caleb Rutledge
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  2. Nerissa U. Ko
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  3. Michael T. Lawton
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  4. Helen Kim
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Corresponding author

Correspondence to Helen Kim.

Additional information

This review is dedicated in memory of William L. Young, MD, for his unwavering dedication, enthusiastic mentorship, and probing science into understanding the pathogenesis of brain AVMs to ultimately improve the lives of people diagnosed with this disease.

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Rutledge, W.C., Ko, N.U., Lawton, M.T. et al. Hemorrhage Rates and Risk Factors in the Natural History Course of Brain Arteriovenous Malformations. Transl. Stroke Res. 5, 538–542 (2014). https://doi.org/10.1007/s12975-014-0351-0

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