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Prospective hemorrhage risk of intracerebral cavernous malformations

K D Flemming1, M J Link, T J H Christianson

  • 1Department of Neurology, Mayo Clinic, Rochester, MN, USA. flemming.kelly@mayo.edu

Neurology
|February 4, 2012
PubMed

Insights

Patients with intracerebral cavernous malformations (ICMs) have a significant risk of symptomatic hemorrhage, especially after a prior bleed. This risk decreases over time, but male gender and multiple ICMs are associated with increased hemorrhage risk.

Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Intracerebral cavernous malformations (ICMs) are vascular malformations that can lead to symptomatic hemorrhage.
  • Understanding the prospective risk and timing of hemorrhage is crucial for patient management.

Purpose of the Study:

  • To describe the prospective risk and timing of symptomatic hemorrhage in a large cohort of patients with intracerebral cavernous malformations (ICMs).

Main Methods:

  • Retrospective identification of patients diagnosed with ICMs between 1989 and 1999.
  • Review of patient records and radiographic data, with follow-up obtained.
  • Calculation of annual hemorrhage risk using incidence rates and analysis of predictive factors.

Main Results:

  • A total of 292 patients with 2,035 patient-years of follow-up were analyzed.
  • The overall annual hemorrhage rate was 6.19% for those with prior hemorrhage, 2.18% for those with non-hemorrhagic symptoms, and 0.33% for asymptomatic cases.
  • Prior hemorrhage, male gender, and multiple ICMs were significant predictors of future hemorrhage, with risk decreasing over time.

Conclusions:

  • The study provides estimates of prospective symptomatic hemorrhage risk in ICM patients, stratified by initial presentation.
  • Prior hemorrhage, male gender, and multiplicity of ICMs are identified as potential predictors of future hemorrhage.
  • Hemorrhage risk in patients with a history of symptomatic hemorrhage decreases over time.
Abstract

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