Epidemiology and natural history of arteriovenous malformations

2001 ◽  
Vol 11 (5) ◽  
pp. 1-5 ◽  
Author(s):  
Christian Stapf ◽  
Jay P. Mohr ◽  
John Pile-Spellman ◽  
Robert A. Solomon ◽  
Ralph L. Sacco ◽  
...  
Keyword(s):  
New York ◽  
Natural History ◽  
Arteriovenous Malformations ◽  
Case Series ◽  
Population Based ◽  
Isolated Populations ◽  
Stroke Study ◽  
History Of ◽  
Prospective Longitudinal

The epidemiology and natural history of cerebral arteriovenous malformations (AVMs) remains incompletely elucidated. Several factors are responsible. With regard to the incidence and prevalence of AVMs, the results of prior studies have suffered because of the retrospective design, the use of nonspecific ICD-9 codes, and a focus on small genetically isolated populations. Recent data from the New York Islands AVM Hemorrhage Study, an ongoing, prospective, population-based survey determining the incidence of AVM-related hemorrhage and the associated rates of morbidity and mortality in a zip code–defined population of 10 million people, suggests that the AVM detection rate is 1.21/100,000 person-years (95% confidence interval [CI] 1.02–1.42) and the incidence of AVM-hemorrhage is 0.42/100,000 person-years (95% CI 0.32–0.55). Contemporaneous data from the Northern Manhattan Stroke Study, a prospective, longitudinal population-based study of nearly 150,000 patients in which the focus is to define the incidence of stroke, suggest the crude incidence for first-ever AVM-related hemorrhage to be 0.55/100,000 person-years (95% CI 0.11–1.61). Efforts are ongoing to study the natural history of both ruptured and unruptured AVMs in these datasets to examine the relevance of prior studies of patients selected for conservative follow up in Finland. In addition, data are being gathered to determine whether risk factors for future hemorrhage, which have previously been established in small case series, are valid when applied to whole populations. Together, these data should help inform therapeutic decisionmaking.

scholarly journals The Natural History of Ossification of Yellow Ligament of the Thoracic Spine on MRI: A Population-Based Cohort Study

2020 ◽  
pp. 219256822090376 ◽  
Author(s):  
Chris Yuk Kwan Tang ◽  
Kenneth Man Chee Cheung ◽  
Dino Samartzis ◽  
Jason Pui Yin Cheung
Keyword(s):  
Cohort Study ◽  
Natural History ◽  
Thoracic Spine ◽  
Population Based ◽  
Close Monitoring ◽  
Level Of Evidence ◽  
Southern Chinese ◽  
History Of ◽  
Prospective Longitudinal

Purpose: To assess the natural history of ossification of yellow ligament (OYL) in the thoracic spine and determine risk factors for progression based on a longitudinal population-based cohort. Methods: A prospective, longitudinal cohort study was performed on a population-based cohort of Southern Chinese volunteers. T2-weighted magnetic resonance imaging (MRI) was used at baseline to identify any OYL and was verified with computed tomography. Follow-up MRI was performed 5 years later. Parameters under study included the size of OYL, levels of involvement, morphology (round, triangular, beak), whether it crossed the midline and any disc degeneration. Results: A total of 114 (6.1%) individuals were identified to have OYL at baseline out of the 1864 individuals. Size progression occurred predominantly at the lower thoracic region. Majority of the new OYL were also in the lower thoracic spine and was associated with higher body mass index (BMI). Smokers were associated with OYL size progression while patients with higher BMI tended to develop new OYL at follow-up. Progression commonly occurred at the lower thoracic levels and regression occurred mostly at the upper thoracic levels. Conclusions: This is the first population-based series addressing the natural history of OYL. Better understanding of the natural history of OYL may provide incentive to introduce preventive measures such as weight reduction and close monitoring for myelopathy development in those at-risk groups for progression. This is especially important for patients with lower thoracic OYL and who are smokers with higher BMI. Level of Evidence: 1 (prognostic study).

scholarly journals S19 The impact of clotting abnormalities on the natural history of idiopathic pulmonary fibrosis: an extended follow up of a population based cohort

Thorax ◽  
2016 ◽  
Vol 71 (Suppl 3) ◽  
pp. A13.1-A13
Author(s):  
V Navaratnam ◽  
AW Fogarty ◽  
T McKeever ◽  
N Thompson ◽  
G Jenkins ◽  
...  
Keyword(s):  
Natural History ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Population Based ◽  
History Of ◽  
The Impact

Mo1806 Natural History of Perianal Crohn's Disease: Long-Term Follow-Up on a Population-Based Cohort

2016 ◽  
Vol 150 (4) ◽  
pp. S781-S782
Author(s):  
Rabilloud Marie-Laure ◽  
Charlène Brochard ◽  
Emma Bajeux ◽  
Siproudhis Laurent ◽  
Jean-François Viel ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Natural History ◽  
Population Based ◽  
Perianal Crohn’S Disease ◽  
Long Term Follow Up ◽  
History Of ◽  
Perianal Crohn's Disease

scholarly journals Management of intracranial aneurysms associated with arteriovenous malformations

2014 ◽  
Vol 37 (3) ◽  
pp. E11 ◽  
Author(s):  
Bruno C. Flores ◽  
Daniel R. Klinger ◽  
Kim l. Rickert ◽  
Samuel l. Barnett ◽  
Babu G. Welch ◽  
...  
Keyword(s):  
Natural History ◽  
Arteriovenous Malformations ◽  
Intracranial Aneurysms ◽  
Case Series ◽  
Classification Systems ◽  
Vascular Lesions ◽  
Difficult Decision ◽  
Hemorrhagic Events ◽  
History Of ◽  
Hemorrhage Risk

Intracranial or brain arteriovenous malformations (BAVMs) are some of the most interesting and challenging lesions treated by the cerebrovascular neurosurgeon. It is generally believed that the combination of BAVMs and intracranial aneurysms (IAs) is associated with higher hemorrhage rates at presentation and higher rehemorrhage rates and thus with a more aggressive course and natural history. There is wide variation in the literature on the prevalence of BAVM-associated aneurysms (range 2.7%–58%), with 10%–20% being most often cited in the largest case series. The risk of intracranial hemorrhage in patients with unruptured BAVMs and coexisting IAs has been reported to be 7% annually, compared with 2%–4% annually for those with BAVM alone. Several different classification systems have been applied in an attempt to better understand the natural history of this combination of lesions and implications for treatment. Independent of the classification used, it is clear that a few subtypes of aneurysms have a direct hemodynamic correlation with the BAVM itself. This is exemplified by the fact that the presence of a distal flow-related or an intranidal aneurysm appears to be associated with an increased hemorrhage risk, when compared with an aneurysm located on a vessel with no direct supply to the BAVM nidus. Debate still exists regarding the etiology of the association between those two vascular lesions, the subsequent implications for patients’ risk of hemorrhagic stroke, and finally the determination of which patients warrant treatment and when. The ultimate goals of the treatment of a BAVM associated with an IA are to prevent hemorrhage, avoid stepwise neurological deterioration, and eliminate the mortality risk associated with recurrent hemorrhagic events. The treatment is only justifiable if the risks associated with an intervention are lower than or equivalent to the long-term risks of disability or mortality caused by the lesion itself. When faced with this difficult decision, a few questions need to be answered by the treating neu-rosurgeon: What is the mode of presentation? What is the symptomatic lesion? Which one of the lesions bled? What is the relationship between the BAVM and IA? Is it possible to safely treat both BAVM and IA? The objective of this review is to discuss the demographics, natural history, classification, and strategies for management of BAVMs associated with IAs.

1012 Natural History of Inflammatory Bowel Disease in Asia: A Follow-Up Population-Based Cohort Study

2014 ◽  
Vol 146 (5) ◽  
pp. S-178
Author(s):  
Siew C. Ng ◽  
Whitney Tang ◽  
H.J. de Silva ◽  
Madunil A. Niriella ◽  
Yasith Udara Senanayake ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cohort Study ◽  
Natural History ◽  
Bowel Disease ◽  
Population Based ◽  
History Of ◽  
Inflammatory Bowel

scholarly journals Natural history of brain arteriovenous malformations: a systematic review

2014 ◽  
Vol 37 (3) ◽  
pp. E7 ◽  
Author(s):  
Isaac Josh Abecassis ◽  
David S. Xu ◽  
H. Hunt Batjer ◽  
Bernard R. Bendok
Keyword(s):  
Natural History ◽  
Arteriovenous Malformations ◽  
Venous Drainage ◽  
Cerebral Arteriovenous Malformations ◽  
Brain Arteriovenous Malformations ◽  
Increased Risk ◽  
Risk Of Rupture ◽  
History Of ◽  
Arterial Aneurysms

Object The authors aimed to systematically review the literature to clarify the natural history of brain arteriovenous malformations (BAVMs). Methods The authors searched PubMed for one or more of the following terms: natural history, brain arteriovenous malformations, cerebral arteriovenous malformations, and risk of rupture. They included studies that reported annual rates of hemorrhage and that included either 100 patients or 5 years of treatment-free follow-up. Results The incidence of BAVMs is 1.12–1.42 cases per 100,000 person-years; 38%–68% of new cases are first-ever hemorrhage. The overall annual rates of hemorrhage for patients with untreated BAVMs range from 2.10% to 4.12%. Consistently implicated in subsequent hemorrhage are initial hemorrhagic presentation, exclusively deep venous drainage, and deep and infrantentorial brain location. The risk for rupture seems to be increased by large nidus size and concurrent arterial aneurysms, although these factors have not been studied as thoroughly. Venous stenosis has not been implicated in increased risk for rupture. Conclusions For patients with BAVMs, although the overall risk for hemorrhage seems to be 2.10%–4.12% per year, calculating an accurate risk profile for decision making involves clinical attention and accounting for specific features of the malformation.

scholarly journals ISCHEMIC STROKE

2016 ◽  
Vol 23 (08) ◽  
pp. 925-931
Author(s):  
Ramesh Kumar ◽  
Muhammad Iqbal Shah ◽  
Manzoor Ali Lakhair ◽  
Zaheer Memon
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Case Series ◽  
Risk Elements ◽  
Stroke Prevalence ◽  
Stroke Study ◽  
Study Results ◽  
Low Hdl ◽  
History Of

Objectives: To determine the frequency of Dyslipidemia and other risk factorsin patients with ischemic stroke. Study design: Descriptive and case series. Setting: Thisresearch study was carried out in the Medicine department of Liaquat University HospitalJamshoro/Hyderabad. Duration of study: Six months. Sample size: Total 100 patients of bothmale and female sex were enrolled in this research study. Results: Total 100 cases of ischemicstroke were included. The mean age + SD (range) was 59.72 + 6.40 (45 – 70 years), 76(76.0%)were males and 24(24.0%) were females. Speech deficits was present in 28(28.0%, n = 100)patients. Eighty seven (87.0%, n = 100) patients had difficulty in walking, 17(17.0%, n = 100)patients had seizures, confusion was observed in 35(35.0%, n = 100) patients, 35(35.0%, n =100) had headache, Vertigo was seen in 11(11.0%n = 100) patients, Visual disturbances wasseen in 14(14.0%, n = 100) cases and 20(20.0%n = 100) patients had vomiting. High bloodpressure was in 51(51.0%, n = 100), diabetes mellitus and dyslipidemia in 30(30.0%, n = 100)respectively. Eighteen (18.0%, n = 100) patients were known cases of cardiovascular diseases,36(36.0%, n = 100) were smokers, 22(22.0%, n = 100) patients had family history of strokeand only 2(2.0%, n = 100) patients had the history of alcoholism. High cholesterol (mg/dL) wasseen in 21(21.0% n = 30) patients, High LDL (mg/dL) in 37(37.0%, n = 30), Low HDL (mg/dL) in90(90.0%, n = 30) and High Triglycerides (mg/dL) were seen in 40(40.0%, n = 30). Conclusion:High Blood pressure, Diabetes mellitus, Dyslipidemia and Smoking are chief risk elements ofischemic stroke. Prevalence of stroke is high in poor socioeconomic demographics with singleor multiple risk elements and this may be because of unawareness about these risk elements,unaffordability of treatment or proper follow up.

scholarly journals Natural history of depression in the oldest old

2006 ◽  
Vol 188 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Max L. Stek ◽  
David J. Vinkers ◽  
Jacobijn Gussekloo ◽  
Roos C. Van Der Mast ◽  
Aartjan T. F. Beekman ◽  
...  
Keyword(s):  
Natural History ◽  
Remission Rate ◽  
Oldest Old ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Population Based ◽  
Negative Consequences ◽  
History Of ◽  
History Of Depression

BackgroundDespite its negative consequences, little is known about the natural history of depression in the oldest old.AimsTo study the incidence, course and predictors of depression in the general population of the oldest old.MethodThe Leiden 85-plus Study is a prospective population-based study of 500 people from their 85th to their 89th birthdays. Depressive symptoms were annually assessed with the 15-item Geriatric Depression Scale, using a cut-off of 4 points.ResultsDuring a mean follow-up of 3.9 years, the annual risk for the emergence of depression was 6.8%. Poor daily functioning and institutionalisation predicted depression. Among the 77 participants with depression at baseline (prevalence 15%) the annual remission rate was ony 14%. In more than half of the participants with a remission of depression, we observed a relapse of depression during follow-up. No predictors of remission could be identified.ConclusionsAmong the oldest old, depression is frequent and highly persistent. More active case-finding and treatment would be potentially rewarding.

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