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Prospective, population-based detection of intracranial vascular malformations in adults: the Scottish Intracranial
Rustam Al-Shahi1, Jo J Bhattacharya, David G Currie
1Department of Clinical Neurosciences, Western General Hospital, Edinburgh, Scotland. Rustam.Al-Shahi@ed.ac.uk
Insights
This study monitored the detection of intracranial vascular malformations (IVMs) in Scotland. The crude detection rate for all IVMs was 2.27 per 100,000 adults annually.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Intracranial vascular malformations (IVMs) are significant causes of neurological deficits.
- No prior prospective, population-based studies have focused on IVM detection rates.
- The Scottish Intracranial Vascular Malformation Study (SIVMS) was established to address this gap.
Purpose of the Study:
- To establish a prospective, population-based cohort for monitoring IVM detection.
- To determine the incidence and epidemiology of various IVM types.
- To provide data for estimating IVM prognosis.
Main Methods:
- Adults (≥16 years) with a first-time IVM diagnosis in Scotland between 1999-2000 were identified.
- Multiple overlapping case ascertainment sources were utilized.
- Diagnostic brain imaging and pathology reports were reviewed for confirmation.
Main Results:
- 190 adults with confirmed IVMs were included from 418 notifications.
- The crude detection rate for all IVMs was 2.27 per 100,000 adults per year.
- Specific rates were determined for brain arteriovenous malformations (AVMs), cavernous, and venous malformations, and dural AVMs.
Conclusions:
- The SIVMS provides crucial data on the public health impact of IVMs.
- This cohort will enable future estimations of IVM prognosis.
- Findings contribute to understanding the comparative epidemiology of different IVM subtypes.
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 >or=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.
